Urine Kidney Injury Biomarkers and Risks of Cardiovascular Disease Events and All-Cause Death: The CRIC Study.
Abstract | BACKGROUND AND OBJECTIVES: DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: RESULTS: At baseline, mean age of study participants was 59.5±10.8 years, 46% were women, and 34% had a self-reported history of any CVD. Median follow-up was 6.5 (interquartile range, 5.6-6.8) years. A total of 333 HF events, 282 atherosclerotic CVD events, and 440 deaths were observed during a median follow-up of 6.5 (interquartile range, 5.6-6.8) years. Those in the highest two quintiles of KIM-1/Cr levels had a higher risk of HF relative to the lowest quintile (quintile 5 versus quintile 1 adjusted hazard ratio [aHR] of 1.73 [95% confidence interval, 1.05 to 2.85]). N-acetyl-β-d- glucosaminidase/Cr was associated with HF in continuous analyses (aHR per log SD higher 1.18 [95% confidence interval, 1.01 to 1.38]). Only KIM-1/Cr was independently associated with atherosclerotic CVD events (aHR per log SD higher 1.21 [95% confidence interval, 1.02 to 1.41]), whereas both KIM-1/Cr (quintile 5 versus quintile 1 aHR of 1.56 [95% confidence interval, 1.06 to 2.31]) and neutrophil gelatinase-associated lipocalin/Cr (quintile 5 versus quintile 1 aHR of 1.82 [95% confidence interval, 1.19 to 2.8]) were associated with all-cause death. CONCLUSIONS: Selected urine kidney injury biomarkers were independently associated with higher risk of HF, CVD events, and death in CRIC. Among the biomarkers examined, only KIM-1/Cr was associated with each outcome. Further work is needed to determine the utility of these biomarkers to improve risk prediction for these adverse outcomes.
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Authors | Meyeon Park, Chi-Yuan Hsu, Alan S Go, Harold I Feldman, Dawei Xie, Xiaoming Zhang, Theodore Mifflin, Sushrut S Waikar, Venkata S Sabbisetti, Joseph V Bonventre, Josef Coresh, Robert G Nelson, Paul L Kimmel, John W Kusek, Mahboob Rahman, Jeffrey R Schelling, Ramachandran S Vasan, Kathleen D Liu, Chronic Renal Insufficiency Cohort (CRIC) Study Investigators, CKD Biomarkers Consortium |
Journal | Clinical journal of the American Society of Nephrology : CJASN
(Clin J Am Soc Nephrol)
Vol. 12
Issue 5
Pg. 761-771
(May 08 2017)
ISSN: 1555-905X [Electronic] United States |
PMID | 28254771
(Publication Type: Journal Article, Multicenter Study)
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Copyright | Copyright © 2017 by the American Society of Nephrology. |
Chemical References |
- Biomarkers
- FABP1 protein, human
- Fatty Acid-Binding Proteins
- HAVCR1 protein, human
- Hepatitis A Virus Cellular Receptor 1
- LCN2 protein, human
- Lipocalin-2
- Acetylglucosaminidase
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Topics |
- Acetylglucosaminidase
(urine)
- Aged
- Biomarkers
(urine)
- Cardiovascular Diseases
(diagnosis, mortality)
- Cause of Death
- Fatty Acid-Binding Proteins
(urine)
- Female
- Hepatitis A Virus Cellular Receptor 1
(analysis)
- Humans
- Lipocalin-2
(urine)
- Male
- Middle Aged
- Multivariate Analysis
- Predictive Value of Tests
- Prognosis
- Proportional Hazards Models
- Prospective Studies
- Renal Insufficiency, Chronic
(diagnosis, mortality, urine)
- Risk Assessment
- Risk Factors
- Time Factors
- United States
(epidemiology)
- Urinalysis
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