Abstract | AIM: METHODS: RESULTS: Twenty-six patients (18.8%) developed a progression of CKD during the follow-up period, as defined by decline in eGFR category accompanied by a ≥25% drop in eGFR form baseline. No difference regarding age, sex, body mass index, hypertension, diabetes or EF was present between patients with and without CKD progression (each P = n.s.). At baseline, creatinine concentrations and eGFR were significantly different between both groups (sCr: 1.50 ± 0.67 vs 1.04 ± 0.37, P = < 0.001; eGFR: 47.8 ± 12.3 vs. 77.3 ± 23.5 mL/min per 1.73m(2) , each P < 0.001). In a Kaplan-Meier-analysis, KIM-1 and NAG were significant predictors for CKD progression (both P < 0.05). In Cox regression analysis, NAG > median (OR 3.25,P = 0.013), initial eGFR (OR 0.94, P < 0.001) and diuretic use (OR 3.92, P = 0.001) were independent predictors of CKD progression. Further, KIM-1 and NAG were also independent predictors of a combined endpoint of CKD progression and all-cause mortality by Cox regression analysis (each P < 0.05). The combination of both markers showed additive value regarding both endpoints. NGAL showed no association with CKD progression. CONCLUSIONS: During long-term follow-up chronic heart failure patients with CKD show a relevant disease progression. The current study emphasizes a strong association of the tubular biomarkers NAG and KIM-1 with CKD progression in chronic heart failure and suggests their usefulness as cardiorenal markers.
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Authors | Carsten G Jungbauer, Ekrem Uecer, Stefan Stadler, Christoph Birner, Stefan Buchner, Lars S Maier, Andreas Luchner |
Journal | Nephrology (Carlton, Vic.)
(Nephrology (Carlton))
Vol. 21
Issue 6
Pg. 490-8
(Jun 2016)
ISSN: 1440-1797 [Electronic] Australia |
PMID | 26422793
(Publication Type: Journal Article)
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Copyright | © 2015 Asian Pacific Society of Nephrology. |
Chemical References |
- Biomarkers
- HAVCR1 protein, human
- Hepatitis A Virus Cellular Receptor 1
- LCN2 protein, human
- Lipocalin-2
- Creatinine
- Acetylglucosaminidase
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Topics |
- Acetylglucosaminidase
(urine)
- Aged
- Biomarkers
(urine)
- Cardio-Renal Syndrome
(diagnosis, mortality, urine)
- Chronic Disease
- Creatinine
(urine)
- Disease Progression
- Female
- Glomerular Filtration Rate
- Heart Failure
(complications, diagnosis, mortality)
- Hepatitis A Virus Cellular Receptor 1
(metabolism)
- Humans
- Kaplan-Meier Estimate
- Kidney
(physiopathology)
- Lipocalin-2
(urine)
- Male
- Middle Aged
- Multivariate Analysis
- Odds Ratio
- Predictive Value of Tests
- Prognosis
- Proportional Hazards Models
- Renal Insufficiency, Chronic
(complications, diagnosis, mortality, urine)
- Risk Factors
- Time Factors
- Urinalysis
|