You are here
Urine Collagen Fragments and CKD Progression-The Cardiovascular Health Study.
Tuesday,2015-04-07 12:42 America/Los_Angeles — zdrager
| Title | Urine Collagen Fragments and CKD Progression-The Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2015 |
| Authors | Ix, JH, Biggs, ML, Mukamal, K, Djoussé, L, Siscovick, D, Tracy, R, Katz, R, Delaney, JA, Chaves, P, Rifkin, DE, Hughes-Austin, JM, Garimella, PS, Sarnak, MJ, Shlipak, MG, Kizer, JR |
| Journal | J Am Soc Nephrol |
| Volume | 26 |
| Issue | 10 |
| Pagination | 2494-503 |
| Date Published | 2015 Oct |
| ISSN | 1533-3450 |
| Keywords | Aged, Cardiovascular Diseases, Case-Control Studies, Disease Progression, Female, Heart Failure, Humans, Kidney Failure, Chronic, Male, Peptide Fragments, Procollagen, Prospective Studies, Renal Insufficiency, Chronic |
| Abstract | <p>Tubulointerstitial fibrosis is common with ageing and strongly prognostic for ESRD but is poorly captured by eGFR or urine albumin to creatinine ratio (ACR). Higher urine levels of procollagen type III N-terminal propeptide (PIIINP) mark the severity of tubulointerstitial fibrosis in biopsy studies, but the association of urine PIIINP with CKD progression is unknown. Among community-living persons aged ≥65 years, we measured PIIINP in spot urine specimens from the 1996 to 1997 Cardiovascular Health Study visit among individuals with CKD progression (30% decline in eGFR over 9 years, n=192) or incident ESRD (n=54) during follow-up, and in 958 randomly selected participants. We evaluated associations of urine PIIINP with CKD progression and incident ESRD. Associations of urine PIIINP with cardiovascular disease, heart failure, and death were evaluated as secondary end points. At baseline, mean age (±SD) was 78±5 years, mean eGFR was 63±18 ml/min per 1.73 m(2), and median urine PIIINP was 2.6 (interquartile range, 1.4-4.2) μg/L. In a case-control study (192 participants, 231 controls), each doubling of urine PIIINP associated with 22% higher odds of CKD progression (adjusted odds ratio, 1.22; 95% confidence interval, 1.00 to 1.49). Higher urine PIIINP level was also associated with incident ESRD, but results were not significant in fully adjusted models. In a prospective study among the 958 randomly selected participants, higher urine PIIINP was significantly associated with death, but not with incident cardiovascular disease or heart failure. These data suggest higher urine PIIINP levels associate with CKD progression independently of eGFR and ACR in older individuals.</p> |
| DOI | 10.1681/ASN.2014070696 |
| Alternate Journal | J. Am. Soc. Nephrol. |
| PubMed ID | 25655067 |
| PubMed Central ID | PMC4587692 |
| Grant List | HHSN268200800007C / / PHS HHS / United States HHSN268201200036C / / PHS HHS / United States N01-HC55222 / HC / NHLBI NIH HHS / United States N01-HC85079 / HC / NHLBI NIH HHS / United States N01-HC85080 / HC / NHLBI NIH HHS / United States N01-HC85081 / HC / NHLBI NIH HHS / United States N01-HC85082 / HC / NHLBI NIH HHS / United States N01-HC85083 / HC / NHLBI NIH HHS / United States N01-HC85086 / HC / NHLBI NIH HHS / United States R01 DK098234 / DK / NIDDK NIH HHS / United States R01-AG023629 / AG / NIA NIH HHS / United States R01-AG027002 / AG / NIA NIH HHS / United States R01-DK098234 / DK / NIDDK NIH HHS / United States R01-HL094555 / HL / NHLBI NIH HHS / United States U01-HL080295 / HL / NHLBI NIH HHS / United States |