Association of TNF Receptor 2 and CRP with GFR Decline in the General Nondiabetic Population.
Clin J Am Soc Nephrol
; 12(4): 624-634, 2017 Apr 03.
Article
em En
| MEDLINE
| ID: mdl-28153935
ABSTRACT
BACKGROUND AND OBJECTIVES:
Higher levels of inflammatory markers have been associated with renal outcomes in diabetic populations. We investigated whether soluble TNF receptor 2 (TNFR2) and high-sensitivity C-reactive protein (hsCRP) were associated with the age-related GFR decline in a nondiabetic population using measured GFR (mGFR). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A representative sample of 1590 middle-aged people from the general population without prevalent kidney disease, diabetes, or cardiovascular disease were enrolled in the Renal Iohexol-Clearance Survey in Tromsø 6 (RENIS-T6) between 2007 and 2009. After a median of 5.6 years, 1296 persons were included in the Renal Iohexol-Clearance Survey Follow-Up Study. GFR was measured using iohexol clearance at baseline and follow-up.RESULTS:
The mean decline of mGFR during the period was -0.84 ml/min per 1.73 m2 per year. There were 133 participants with rapid mGFR decline, defined as an annual mGFR loss >3.0 ml/min per 1.73 m2, and 26 participants with incident CKD, defined as mGFR<60 ml/min per 1.73 m2 at follow-up. In multivariable adjusted mixed models, 1 mg/L higher levels of hsCRP were associated with an accelerated decline in mGFR of -0.03 ml/min per 1.73 m2 per year (95% confidence interval [95% CI], -0.05 to -0.01), and 1 SD higher TNFR2 was associated with a slower decline in mGFR (0.09 ml/min per 1.73 m2 per year; 95% CI, 0.01 to 0.18). In logistic regression models adjusted for sex, age, weight, and height, 1 mg/L higher levels of hsCRP were associated with higher risk of rapid mGFR decline (odds ratio, 1.03; 95% CI, 1.01 to 1.06) and incident CKD (odds ratio, 1.04; 95% CI, 1.00 to 1.08).CONCLUSIONS:
Higher baseline levels of hsCRP but not TNFR2 were associated with accelerated age-related mGFR decline and incident CKD in a general nondiabetic population.Palavras-chave
C-Reactive Protein; Cardiovascular Diseases; Follow-Up Studies; GFR decline; Humans; Inflammation; Iohexol, kidney; Kidney Function Tests; Logistic Models; Measured GFR; Middle Aged; Odds Ratio; Receptors, Tumor Necrosis Factor, Type II; Renal Insufficiency, Chronic; Surveys and Questionnaires; TNFRSF1B protein, human; aging; chronic kidney disease; cytokines; diabetes mellitus; glomerular filtration rate; soluble TNF receptors
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Envelhecimento
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Proteína C-Reativa
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Receptores Tipo II do Fator de Necrose Tumoral
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Insuficiência Renal Crônica
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Taxa de Filtração Glomerular
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article