Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients
Background. Chronic transplant dysfunction is characterized by a gradual decline in renal function with slowly rising serum creatinine. The underlying mechanism is thought to include inflammation and atherosclerosis. C-reactive protein (CRP) is a well-established marker of both inflammation and athe...
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| creator | van Ree, Rutger M. Oterdoom, Leendert H. de Vries, Aiko P. J. Gansevoort, Ron T. van der Heide, Jaap J. Homan van Son, Willem J. Ploeg, Rutger J. de Jong, Paul E. Gans, Reinold O. B. Bakker, Stephan J. L. |
| description | Background. Chronic transplant dysfunction is characterized by a gradual decline in renal function with slowly rising serum creatinine. The underlying mechanism is thought to include inflammation and atherosclerosis. C-reactive protein (CRP) is a well-established marker of both inflammation and atherosclerosis. In this prospective study, we investigated whether CRP could be of use as a clinical marker for early identification of renal transplant recipients at increased risk of deterioration of graft function. Methods. In this prospective study, all participating patients (n = 606) visited the out-patient clinic at least once a year, and serum creatinine was assessed at every visit. Subjects with a follow-up of 1 year post-transplantation. Further prospective studies are required to investigate whether early intervention can prevent deterioration of graft function in subjects with elevated levels of CRP. |
| doi_str_mv | 10.1093/ndt/gfl511 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68377467</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ndt/gfl511</oup_id><sourcerecordid>19515993</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-b696fc9a7554c08ce040e7f6d0d7c305eadb8f368262e3855ff8e6f3ef4cfe443</originalsourceid><addsrcrecordid>eNqFkV1rFDEUhgdRbK3e-ANkEPRCGJvvj0tZalcsqKAg3oRs5qSkzs6MSabYP-Dv9rS7uOCF3uSQN0_e5Jy3aZ5S8poSy0_Hvp5exkFSeq85pkKRjnEj7zfHeEg7Iok9ah6VckUIsUzrh80RVdYaxthx8-tsgGtfoW-xwlDaKbarLoMPNV1DO-epQhrbNPYwAy5jHW5QhT6F2voQYIB8d72HCjlNuEnTeOtymX2sbVzGcKegSYbRD23Nfizz4MeKQkhzQs_yuHkQ_VDgyb6eNF_enn1erbuLD-fvVm8uuiAErd1GWRWD9VpKEYgJQAQBHVVPeh04keD7jYlcGaYY4AxkjAZU5BBFiCAEP2le7nyxsR8LlOq2qWAT-B2YluKU4VoLpf8LUiuptJYj-Pwv8GpaMjZaHKOGSskNQ-jVDgp5KiVDdHNOW59vHCXuNkOHGbpdhgg_2zsumy30B3QfGgIv9oAvwQ8RBxpSOXBGaK6VOHDTMv_7wW7HpVLh5x_S5-8OJ6GlW3_95s4FWbNP7z-6Ff8Ni-HD6Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>218155382</pqid></control><display><type>article</type><title>Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Freely accessible e-journals</source><source>Alma/SFX Local Collection</source><creator>van Ree, Rutger M. ; Oterdoom, Leendert H. ; de Vries, Aiko P. J. ; Gansevoort, Ron T. ; van der Heide, Jaap J. Homan ; van Son, Willem J. ; Ploeg, Rutger J. ; de Jong, Paul E. ; Gans, Reinold O. B. ; Bakker, Stephan J. L.</creator><creatorcontrib>van Ree, Rutger M. ; Oterdoom, Leendert H. ; de Vries, Aiko P. J. ; Gansevoort, Ron T. ; van der Heide, Jaap J. Homan ; van Son, Willem J. ; Ploeg, Rutger J. ; de Jong, Paul E. ; Gans, Reinold O. B. ; Bakker, Stephan J. L. ; on behalf of the Renal Transplant Program, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands</creatorcontrib><description>Background. Chronic transplant dysfunction is characterized by a gradual decline in renal function with slowly rising serum creatinine. The underlying mechanism is thought to include inflammation and atherosclerosis. C-reactive protein (CRP) is a well-established marker of both inflammation and atherosclerosis. In this prospective study, we investigated whether CRP could be of use as a clinical marker for early identification of renal transplant recipients at increased risk of deterioration of graft function. Methods. In this prospective study, all participating patients (n = 606) visited the out-patient clinic at least once a year, and serum creatinine was assessed at every visit. Subjects with a follow-up of <1 year (n = 31) were excluded from analysis. Results. A total of 575 patients participated at a median (interquartile range) time of 5.9 (2.6–11.3) years post-transplantation. Median time of follow-up was 3.0 (2.4–3.4) years. Changes in serum creatinine during follow-up were −0.45 (−4.83–4.76) µmol/l/year in 172 subjects with CRP <1.0 mg/l, 1.04 (−3.36–6.12) µmol/l/year in 184 subjects with CRP 1.0–3.0 mg/l and 2.34 (−3.33–9.07) µmol/l/year in 219 subjects with CRP >3.0 mg/l (P < 0.05 for comparison of the three groups). Proteinuria (P = 0.003), CMV IgG titre (P = 0.01), donor age (P = 0.01), CRP concentration (P = 0.02), recipient age (P = 0.02) and recipient gender (P = 0.047) were independently associated with change in serum creatinine during follow-up in a multivariate analysis. Conclusions. Elevated levels of CRP independently predict accelerated deterioration of graft function in renal transplant recipients >1 year post-transplantation. Further prospective studies are required to investigate whether early intervention can prevent deterioration of graft function in subjects with elevated levels of CRP.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfl511</identifier><identifier>PMID: 16998222</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; C-reactive protein ; C-Reactive Protein - biosynthesis ; Cardiovascular Diseases - metabolism ; cardiovascular risk ; chronic transplant dysfunction ; Creatinine - blood ; Cytomegalovirus ; Cytomegalovirus - metabolism ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Graft Rejection - diagnosis ; Graft Survival ; Humans ; Immunosuppressive Agents - pharmacology ; Intensive care medicine ; Kidney Transplantation - methods ; Male ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Prognosis ; Regression Analysis ; Renal failure ; renal transplantation ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system</subject><ispartof>Nephrology, dialysis, transplantation, 2007-01, Vol.22 (1), p.246-253</ispartof><rights>The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org 2006</rights><rights>2007 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) Jan 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-b696fc9a7554c08ce040e7f6d0d7c305eadb8f368262e3855ff8e6f3ef4cfe443</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27933,27934</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18473764$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16998222$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Ree, Rutger M.</creatorcontrib><creatorcontrib>Oterdoom, Leendert H.</creatorcontrib><creatorcontrib>de Vries, Aiko P. J.</creatorcontrib><creatorcontrib>Gansevoort, Ron T.</creatorcontrib><creatorcontrib>van der Heide, Jaap J. Homan</creatorcontrib><creatorcontrib>van Son, Willem J.</creatorcontrib><creatorcontrib>Ploeg, Rutger J.</creatorcontrib><creatorcontrib>de Jong, Paul E.</creatorcontrib><creatorcontrib>Gans, Reinold O. B.</creatorcontrib><creatorcontrib>Bakker, Stephan J. L.</creatorcontrib><creatorcontrib>on behalf of the Renal Transplant Program, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands</creatorcontrib><title>Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><description>Background. Chronic transplant dysfunction is characterized by a gradual decline in renal function with slowly rising serum creatinine. The underlying mechanism is thought to include inflammation and atherosclerosis. C-reactive protein (CRP) is a well-established marker of both inflammation and atherosclerosis. In this prospective study, we investigated whether CRP could be of use as a clinical marker for early identification of renal transplant recipients at increased risk of deterioration of graft function. Methods. In this prospective study, all participating patients (n = 606) visited the out-patient clinic at least once a year, and serum creatinine was assessed at every visit. Subjects with a follow-up of <1 year (n = 31) were excluded from analysis. Results. A total of 575 patients participated at a median (interquartile range) time of 5.9 (2.6–11.3) years post-transplantation. Median time of follow-up was 3.0 (2.4–3.4) years. Changes in serum creatinine during follow-up were −0.45 (−4.83–4.76) µmol/l/year in 172 subjects with CRP <1.0 mg/l, 1.04 (−3.36–6.12) µmol/l/year in 184 subjects with CRP 1.0–3.0 mg/l and 2.34 (−3.33–9.07) µmol/l/year in 219 subjects with CRP >3.0 mg/l (P < 0.05 for comparison of the three groups). Proteinuria (P = 0.003), CMV IgG titre (P = 0.01), donor age (P = 0.01), CRP concentration (P = 0.02), recipient age (P = 0.02) and recipient gender (P = 0.047) were independently associated with change in serum creatinine during follow-up in a multivariate analysis. Conclusions. Elevated levels of CRP independently predict accelerated deterioration of graft function in renal transplant recipients >1 year post-transplantation. Further prospective studies are required to investigate whether early intervention can prevent deterioration of graft function in subjects with elevated levels of CRP.</description><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - biosynthesis</subject><subject>Cardiovascular Diseases - metabolism</subject><subject>cardiovascular risk</subject><subject>chronic transplant dysfunction</subject><subject>Creatinine - blood</subject><subject>Cytomegalovirus</subject><subject>Cytomegalovirus - metabolism</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>Graft Rejection - diagnosis</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Immunosuppressive Agents - pharmacology</subject><subject>Intensive care medicine</subject><subject>Kidney Transplantation - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Prognosis</subject><subject>Regression Analysis</subject><subject>Renal failure</subject><subject>renal transplantation</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV1rFDEUhgdRbK3e-ANkEPRCGJvvj0tZalcsqKAg3oRs5qSkzs6MSabYP-Dv9rS7uOCF3uSQN0_e5Jy3aZ5S8poSy0_Hvp5exkFSeq85pkKRjnEj7zfHeEg7Iok9ah6VckUIsUzrh80RVdYaxthx8-tsgGtfoW-xwlDaKbarLoMPNV1DO-epQhrbNPYwAy5jHW5QhT6F2voQYIB8d72HCjlNuEnTeOtymX2sbVzGcKegSYbRD23Nfizz4MeKQkhzQs_yuHkQ_VDgyb6eNF_enn1erbuLD-fvVm8uuiAErd1GWRWD9VpKEYgJQAQBHVVPeh04keD7jYlcGaYY4AxkjAZU5BBFiCAEP2le7nyxsR8LlOq2qWAT-B2YluKU4VoLpf8LUiuptJYj-Pwv8GpaMjZaHKOGSskNQ-jVDgp5KiVDdHNOW59vHCXuNkOHGbpdhgg_2zsumy30B3QfGgIv9oAvwQ8RBxpSOXBGaK6VOHDTMv_7wW7HpVLh5x_S5-8OJ6GlW3_95s4FWbNP7z-6Ff8Ni-HD6Q</recordid><startdate>20070101</startdate><enddate>20070101</enddate><creator>van Ree, Rutger M.</creator><creator>Oterdoom, Leendert H.</creator><creator>de Vries, Aiko P. J.</creator><creator>Gansevoort, Ron T.</creator><creator>van der Heide, Jaap J. Homan</creator><creator>van Son, Willem J.</creator><creator>Ploeg, Rutger J.</creator><creator>de Jong, Paul E.</creator><creator>Gans, Reinold O. B.</creator><creator>Bakker, Stephan J. L.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20070101</creationdate><title>Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients</title><author>van Ree, Rutger M. ; Oterdoom, Leendert H. ; de Vries, Aiko P. J. ; Gansevoort, Ron T. ; van der Heide, Jaap J. Homan ; van Son, Willem J. ; Ploeg, Rutger J. ; de Jong, Paul E. ; Gans, Reinold O. B. ; Bakker, Stephan J. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-b696fc9a7554c08ce040e7f6d0d7c305eadb8f368262e3855ff8e6f3ef4cfe443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>C-reactive protein</topic><topic>C-Reactive Protein - biosynthesis</topic><topic>Cardiovascular Diseases - metabolism</topic><topic>cardiovascular risk</topic><topic>chronic transplant dysfunction</topic><topic>Creatinine - blood</topic><topic>Cytomegalovirus</topic><topic>Cytomegalovirus - metabolism</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Female</topic><topic>Graft Rejection - diagnosis</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Immunosuppressive Agents - pharmacology</topic><topic>Intensive care medicine</topic><topic>Kidney Transplantation - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Prognosis</topic><topic>Regression Analysis</topic><topic>Renal failure</topic><topic>renal transplantation</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Ree, Rutger M.</creatorcontrib><creatorcontrib>Oterdoom, Leendert H.</creatorcontrib><creatorcontrib>de Vries, Aiko P. J.</creatorcontrib><creatorcontrib>Gansevoort, Ron T.</creatorcontrib><creatorcontrib>van der Heide, Jaap J. Homan</creatorcontrib><creatorcontrib>van Son, Willem J.</creatorcontrib><creatorcontrib>Ploeg, Rutger J.</creatorcontrib><creatorcontrib>de Jong, Paul E.</creatorcontrib><creatorcontrib>Gans, Reinold O. B.</creatorcontrib><creatorcontrib>Bakker, Stephan J. L.</creatorcontrib><creatorcontrib>on behalf of the Renal Transplant Program, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Ree, Rutger M.</au><au>Oterdoom, Leendert H.</au><au>de Vries, Aiko P. J.</au><au>Gansevoort, Ron T.</au><au>van der Heide, Jaap J. Homan</au><au>van Son, Willem J.</au><au>Ploeg, Rutger J.</au><au>de Jong, Paul E.</au><au>Gans, Reinold O. B.</au><au>Bakker, Stephan J. L.</au><aucorp>on behalf of the Renal Transplant Program, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2007-01-01</date><risdate>2007</risdate><volume>22</volume><issue>1</issue><spage>246</spage><epage>253</epage><pages>246-253</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>Background. Chronic transplant dysfunction is characterized by a gradual decline in renal function with slowly rising serum creatinine. The underlying mechanism is thought to include inflammation and atherosclerosis. C-reactive protein (CRP) is a well-established marker of both inflammation and atherosclerosis. In this prospective study, we investigated whether CRP could be of use as a clinical marker for early identification of renal transplant recipients at increased risk of deterioration of graft function. Methods. In this prospective study, all participating patients (n = 606) visited the out-patient clinic at least once a year, and serum creatinine was assessed at every visit. Subjects with a follow-up of <1 year (n = 31) were excluded from analysis. Results. A total of 575 patients participated at a median (interquartile range) time of 5.9 (2.6–11.3) years post-transplantation. Median time of follow-up was 3.0 (2.4–3.4) years. Changes in serum creatinine during follow-up were −0.45 (−4.83–4.76) µmol/l/year in 172 subjects with CRP <1.0 mg/l, 1.04 (−3.36–6.12) µmol/l/year in 184 subjects with CRP 1.0–3.0 mg/l and 2.34 (−3.33–9.07) µmol/l/year in 219 subjects with CRP >3.0 mg/l (P < 0.05 for comparison of the three groups). Proteinuria (P = 0.003), CMV IgG titre (P = 0.01), donor age (P = 0.01), CRP concentration (P = 0.02), recipient age (P = 0.02) and recipient gender (P = 0.047) were independently associated with change in serum creatinine during follow-up in a multivariate analysis. Conclusions. Elevated levels of CRP independently predict accelerated deterioration of graft function in renal transplant recipients >1 year post-transplantation. Further prospective studies are required to investigate whether early intervention can prevent deterioration of graft function in subjects with elevated levels of CRP.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>16998222</pmid><doi>10.1093/ndt/gfl511</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences C-reactive protein C-Reactive Protein - biosynthesis Cardiovascular Diseases - metabolism cardiovascular risk chronic transplant dysfunction Creatinine - blood Cytomegalovirus Cytomegalovirus - metabolism Emergency and intensive care: renal failure. Dialysis management Female Graft Rejection - diagnosis Graft Survival Humans Immunosuppressive Agents - pharmacology Intensive care medicine Kidney Transplantation - methods Male Medical sciences Middle Aged Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Prognosis Regression Analysis Renal failure renal transplantation Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system |
| title | Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients |
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