Novel Risk Factors for Progression of Diabetic and Nondiabetic CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study
Identification of novel risk factors for chronic kidney disease (CKD) progression may inform mechanistic investigations and improve identification of high-risk subgroups. The current study aimed to characterize CKD progression across levels of numerous risk factors and identify independent risk fact...
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| Veröffentlicht in: | American journal of kidney diseases 2021-01, Vol.77 (1), p.56-73.e1 |
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| creator | Anderson, Amanda H. Xie, Dawei Wang, Xue Baudier, Robin L. Orlandi, Paula Appel, Lawrence J. Dember, Laura M. He, Jiang Kusek, John W. Lash, James P. Navaneethan, Sankar D. Ojo, Akinlolu Rahman, Mahboob Roy, Jason Scialla, Julia J. Sondheimer, James H. Steigerwalt, Susan P. Wilson, F. Perry Wolf, Myles Feldman, Harold I. Go, Alan S. Townsend, Raymond R. |
| description | Identification of novel risk factors for chronic kidney disease (CKD) progression may inform mechanistic investigations and improve identification of high-risk subgroups. The current study aimed to characterize CKD progression across levels of numerous risk factors and identify independent risk factors for CKD progression among those with and without diabetes.
The Chronic Renal Insufficiency Cohort (CRIC) Study is a prospective cohort study of adults with CKD conducted at 7 US clinical centers.
Participants (N=3,379) had up to 12.3 years of follow-up; 47% had diabetes.
30 risk factors for CKD progression across sociodemographic, behavioral, clinical, and biochemical domains at baseline.
Study outcomes were estimated glomerular filtration rate (eGFR) slope and the composite of halving of eGFR or initiation of kidney replacement therapy.
Stepwise selection of independent risk factors was performed stratified by diabetes status using linear mixed-effects and Cox proportional hazards models.
Among those without and with diabetes, respectively, mean eGFR slope was−1.4±3.3 and−2.7±4.7mL/min/1.73m2 per year. Among participants with diabetes, multivariable-adjusted hazard of the composite outcome was approximately 2-fold or greater with higher levels of the inflammatory chemokine CXCL12, the cardiac marker N-terminal pro–B-type natriuretic peptide (NT-proBNP), and the kidney injury marker urinary neutrophil gelatinase-associated lipocalin (NGAL). Among those without diabetes, low serum bicarbonate and higher high-sensitivity troponin T, NT-proBNP, and urinary NGAL levels were all significantly associated with a 1.5-fold or greater rate of the composite outcome.
The observational study design precludes causal inference.
Strong associations for cardiac markers, plasma CXCL12, and urinary NGAL are comparable to that of systolic blood pressure≥140mm Hg, a well-established risk factor for CKD progression. This warrants further investigation into the potential mechanisms that these markers indicate and opportunities to use them to improve risk stratification.
[Display omitted] |
| doi_str_mv | 10.1053/j.ajkd.2020.07.011 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7752839</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0272638620309252</els_id><sourcerecordid>2439621629</sourcerecordid><originalsourceid>FETCH-LOGICAL-c521t-71cf6849672a1e90c460616ccddcf09779706c2edb779303f4cb192a3930d32d3</originalsourceid><addsrcrecordid>eNp9kc9uEzEQxi0EoiHwAhyQj-Wwi__s2rsIVUJbQqNWBQU4W449mzjd2MXejZQH4L3ZNG1VLpxmxvPNN9b8EHpLSU5JyT9scr25sTkjjORE5oTSZ2hCS8YzUfHqOZoQJlkmeCVO0KuUNoSQmgvxEp1wVglRFmSC_lyHHXR44dINnmnTh5hwGyL-HsMqQkoueBxafO70EnpnsPYWXwdvH-rm8vwjnrnxwa8SnsWwxf0acLOOwY_tBXjd4blPQ9s648CbPW7COsQenzaLefMe_-gHu3-NXrS6S_DmPk7Rr9mXn81FdvXt67z5fJWZktE-k9S0oipqIZmmUBNTCCKoMMZa05JayloSYRjY5ZhywtvCLGnNNB8Ly5nlU3R29L0dlluwBnwfdaduo9vquFdBO_Vvx7u1WoWdkrJk1WgzRaf3BjH8HiD1auuSga7THsKQFCt4LRgV7CBlR6mJIaUI7eMaStSBn9qoAz914KeIVCO_cejd0w8-jjwAGwWfjgIYz7RzEFW6OytYF8H0ygb3P_-_DT6spw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2439621629</pqid></control><display><type>article</type><title>Novel Risk Factors for Progression of Diabetic and Nondiabetic CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Anderson, Amanda H. ; Xie, Dawei ; Wang, Xue ; Baudier, Robin L. ; Orlandi, Paula ; Appel, Lawrence J. ; Dember, Laura M. ; He, Jiang ; Kusek, John W. ; Lash, James P. ; Navaneethan, Sankar D. ; Ojo, Akinlolu ; Rahman, Mahboob ; Roy, Jason ; Scialla, Julia J. ; Sondheimer, James H. ; Steigerwalt, Susan P. ; Wilson, F. Perry ; Wolf, Myles ; Feldman, Harold I. ; Go, Alan S. ; Townsend, Raymond R.</creator><creatorcontrib>Anderson, Amanda H. ; Xie, Dawei ; Wang, Xue ; Baudier, Robin L. ; Orlandi, Paula ; Appel, Lawrence J. ; Dember, Laura M. ; He, Jiang ; Kusek, John W. ; Lash, James P. ; Navaneethan, Sankar D. ; Ojo, Akinlolu ; Rahman, Mahboob ; Roy, Jason ; Scialla, Julia J. ; Sondheimer, James H. ; Steigerwalt, Susan P. ; Wilson, F. Perry ; Wolf, Myles ; Feldman, Harold I. ; Go, Alan S. ; Townsend, Raymond R. ; CRIC Study Investigators</creatorcontrib><description>Identification of novel risk factors for chronic kidney disease (CKD) progression may inform mechanistic investigations and improve identification of high-risk subgroups. The current study aimed to characterize CKD progression across levels of numerous risk factors and identify independent risk factors for CKD progression among those with and without diabetes.
The Chronic Renal Insufficiency Cohort (CRIC) Study is a prospective cohort study of adults with CKD conducted at 7 US clinical centers.
Participants (N=3,379) had up to 12.3 years of follow-up; 47% had diabetes.
30 risk factors for CKD progression across sociodemographic, behavioral, clinical, and biochemical domains at baseline.
Study outcomes were estimated glomerular filtration rate (eGFR) slope and the composite of halving of eGFR or initiation of kidney replacement therapy.
Stepwise selection of independent risk factors was performed stratified by diabetes status using linear mixed-effects and Cox proportional hazards models.
Among those without and with diabetes, respectively, mean eGFR slope was−1.4±3.3 and−2.7±4.7mL/min/1.73m2 per year. Among participants with diabetes, multivariable-adjusted hazard of the composite outcome was approximately 2-fold or greater with higher levels of the inflammatory chemokine CXCL12, the cardiac marker N-terminal pro–B-type natriuretic peptide (NT-proBNP), and the kidney injury marker urinary neutrophil gelatinase-associated lipocalin (NGAL). Among those without diabetes, low serum bicarbonate and higher high-sensitivity troponin T, NT-proBNP, and urinary NGAL levels were all significantly associated with a 1.5-fold or greater rate of the composite outcome.
The observational study design precludes causal inference.
Strong associations for cardiac markers, plasma CXCL12, and urinary NGAL are comparable to that of systolic blood pressure≥140mm Hg, a well-established risk factor for CKD progression. This warrants further investigation into the potential mechanisms that these markers indicate and opportunities to use them to improve risk stratification.
[Display omitted]</description><identifier>ISSN: 0272-6386</identifier><identifier>ISSN: 1523-6838</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2020.07.011</identifier><identifier>PMID: 32866540</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Blood Pressure - physiology ; Cardiometabolic Risk Factors ; Chemokine CXCL12 - blood ; Chronic kidney disease (CKD) ; CKD progression ; CXCL12 ; diabetes ; Diabetic Nephropathies - diagnosis ; Diabetic Nephropathies - epidemiology ; Diabetic Nephropathies - metabolism ; Diabetic Nephropathies - physiopathology ; Disease Progression ; eGFR slope ; end-stage renal disease (ESRD) ; estimated glomerular filtration rate (eGFR) ; Female ; halving of eGFR ; Humans ; inflammatory chemokines ; kidney replacement therapy (KRT) ; Life Style ; Lipocalin-2 - urine ; Male ; Middle Aged ; N-terminal pro-B-type natriuretic peptide (NTproBNP) ; neutrophil gelatinase-associated lipocalin (NGAL) ; Prognosis ; Prospective Studies ; renal function trajectory ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - metabolism ; Renal Insufficiency, Chronic - physiopathology ; Risk Assessment - methods ; risk stratification ; Socioeconomic Factors ; United States - epidemiology</subject><ispartof>American journal of kidney diseases, 2021-01, Vol.77 (1), p.56-73.e1</ispartof><rights>2020 The Authors</rights><rights>Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c521t-71cf6849672a1e90c460616ccddcf09779706c2edb779303f4cb192a3930d32d3</citedby><cites>FETCH-LOGICAL-c521t-71cf6849672a1e90c460616ccddcf09779706c2edb779303f4cb192a3930d32d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.ajkd.2020.07.011$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32866540$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anderson, Amanda H.</creatorcontrib><creatorcontrib>Xie, Dawei</creatorcontrib><creatorcontrib>Wang, Xue</creatorcontrib><creatorcontrib>Baudier, Robin L.</creatorcontrib><creatorcontrib>Orlandi, Paula</creatorcontrib><creatorcontrib>Appel, Lawrence J.</creatorcontrib><creatorcontrib>Dember, Laura M.</creatorcontrib><creatorcontrib>He, Jiang</creatorcontrib><creatorcontrib>Kusek, John W.</creatorcontrib><creatorcontrib>Lash, James P.</creatorcontrib><creatorcontrib>Navaneethan, Sankar D.</creatorcontrib><creatorcontrib>Ojo, Akinlolu</creatorcontrib><creatorcontrib>Rahman, Mahboob</creatorcontrib><creatorcontrib>Roy, Jason</creatorcontrib><creatorcontrib>Scialla, Julia J.</creatorcontrib><creatorcontrib>Sondheimer, James H.</creatorcontrib><creatorcontrib>Steigerwalt, Susan P.</creatorcontrib><creatorcontrib>Wilson, F. Perry</creatorcontrib><creatorcontrib>Wolf, Myles</creatorcontrib><creatorcontrib>Feldman, Harold I.</creatorcontrib><creatorcontrib>Go, Alan S.</creatorcontrib><creatorcontrib>Townsend, Raymond R.</creatorcontrib><creatorcontrib>CRIC Study Investigators</creatorcontrib><title>Novel Risk Factors for Progression of Diabetic and Nondiabetic CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Identification of novel risk factors for chronic kidney disease (CKD) progression may inform mechanistic investigations and improve identification of high-risk subgroups. The current study aimed to characterize CKD progression across levels of numerous risk factors and identify independent risk factors for CKD progression among those with and without diabetes.
The Chronic Renal Insufficiency Cohort (CRIC) Study is a prospective cohort study of adults with CKD conducted at 7 US clinical centers.
Participants (N=3,379) had up to 12.3 years of follow-up; 47% had diabetes.
30 risk factors for CKD progression across sociodemographic, behavioral, clinical, and biochemical domains at baseline.
Study outcomes were estimated glomerular filtration rate (eGFR) slope and the composite of halving of eGFR or initiation of kidney replacement therapy.
Stepwise selection of independent risk factors was performed stratified by diabetes status using linear mixed-effects and Cox proportional hazards models.
Among those without and with diabetes, respectively, mean eGFR slope was−1.4±3.3 and−2.7±4.7mL/min/1.73m2 per year. Among participants with diabetes, multivariable-adjusted hazard of the composite outcome was approximately 2-fold or greater with higher levels of the inflammatory chemokine CXCL12, the cardiac marker N-terminal pro–B-type natriuretic peptide (NT-proBNP), and the kidney injury marker urinary neutrophil gelatinase-associated lipocalin (NGAL). Among those without diabetes, low serum bicarbonate and higher high-sensitivity troponin T, NT-proBNP, and urinary NGAL levels were all significantly associated with a 1.5-fold or greater rate of the composite outcome.
The observational study design precludes causal inference.
Strong associations for cardiac markers, plasma CXCL12, and urinary NGAL are comparable to that of systolic blood pressure≥140mm Hg, a well-established risk factor for CKD progression. This warrants further investigation into the potential mechanisms that these markers indicate and opportunities to use them to improve risk stratification.
[Display omitted]</description><subject>Blood Pressure - physiology</subject><subject>Cardiometabolic Risk Factors</subject><subject>Chemokine CXCL12 - blood</subject><subject>Chronic kidney disease (CKD)</subject><subject>CKD progression</subject><subject>CXCL12</subject><subject>diabetes</subject><subject>Diabetic Nephropathies - diagnosis</subject><subject>Diabetic Nephropathies - epidemiology</subject><subject>Diabetic Nephropathies - metabolism</subject><subject>Diabetic Nephropathies - physiopathology</subject><subject>Disease Progression</subject><subject>eGFR slope</subject><subject>end-stage renal disease (ESRD)</subject><subject>estimated glomerular filtration rate (eGFR)</subject><subject>Female</subject><subject>halving of eGFR</subject><subject>Humans</subject><subject>inflammatory chemokines</subject><subject>kidney replacement therapy (KRT)</subject><subject>Life Style</subject><subject>Lipocalin-2 - urine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>N-terminal pro-B-type natriuretic peptide (NTproBNP)</subject><subject>neutrophil gelatinase-associated lipocalin (NGAL)</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>renal function trajectory</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - metabolism</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Risk Assessment - methods</subject><subject>risk stratification</subject><subject>Socioeconomic Factors</subject><subject>United States - epidemiology</subject><issn>0272-6386</issn><issn>1523-6838</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9uEzEQxi0EoiHwAhyQj-Wwi__s2rsIVUJbQqNWBQU4W449mzjd2MXejZQH4L3ZNG1VLpxmxvPNN9b8EHpLSU5JyT9scr25sTkjjORE5oTSZ2hCS8YzUfHqOZoQJlkmeCVO0KuUNoSQmgvxEp1wVglRFmSC_lyHHXR44dINnmnTh5hwGyL-HsMqQkoueBxafO70EnpnsPYWXwdvH-rm8vwjnrnxwa8SnsWwxf0acLOOwY_tBXjd4blPQ9s648CbPW7COsQenzaLefMe_-gHu3-NXrS6S_DmPk7Rr9mXn81FdvXt67z5fJWZktE-k9S0oipqIZmmUBNTCCKoMMZa05JayloSYRjY5ZhywtvCLGnNNB8Ly5nlU3R29L0dlluwBnwfdaduo9vquFdBO_Vvx7u1WoWdkrJk1WgzRaf3BjH8HiD1auuSga7THsKQFCt4LRgV7CBlR6mJIaUI7eMaStSBn9qoAz914KeIVCO_cejd0w8-jjwAGwWfjgIYz7RzEFW6OytYF8H0ygb3P_-_DT6spw</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Anderson, Amanda H.</creator><creator>Xie, Dawei</creator><creator>Wang, Xue</creator><creator>Baudier, Robin L.</creator><creator>Orlandi, Paula</creator><creator>Appel, Lawrence J.</creator><creator>Dember, Laura M.</creator><creator>He, Jiang</creator><creator>Kusek, John W.</creator><creator>Lash, James P.</creator><creator>Navaneethan, Sankar D.</creator><creator>Ojo, Akinlolu</creator><creator>Rahman, Mahboob</creator><creator>Roy, Jason</creator><creator>Scialla, Julia J.</creator><creator>Sondheimer, James H.</creator><creator>Steigerwalt, Susan P.</creator><creator>Wilson, F. 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Perry ; Wolf, Myles ; Feldman, Harold I. ; Go, Alan S. ; Townsend, Raymond R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c521t-71cf6849672a1e90c460616ccddcf09779706c2edb779303f4cb192a3930d32d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Blood Pressure - physiology</topic><topic>Cardiometabolic Risk Factors</topic><topic>Chemokine CXCL12 - blood</topic><topic>Chronic kidney disease (CKD)</topic><topic>CKD progression</topic><topic>CXCL12</topic><topic>diabetes</topic><topic>Diabetic Nephropathies - diagnosis</topic><topic>Diabetic Nephropathies - epidemiology</topic><topic>Diabetic Nephropathies - metabolism</topic><topic>Diabetic Nephropathies - physiopathology</topic><topic>Disease Progression</topic><topic>eGFR slope</topic><topic>end-stage renal disease (ESRD)</topic><topic>estimated glomerular filtration rate (eGFR)</topic><topic>Female</topic><topic>halving of eGFR</topic><topic>Humans</topic><topic>inflammatory chemokines</topic><topic>kidney replacement therapy (KRT)</topic><topic>Life Style</topic><topic>Lipocalin-2 - urine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>N-terminal pro-B-type natriuretic peptide (NTproBNP)</topic><topic>neutrophil gelatinase-associated lipocalin (NGAL)</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>renal function trajectory</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - metabolism</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Risk Assessment - methods</topic><topic>risk stratification</topic><topic>Socioeconomic Factors</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anderson, Amanda H.</creatorcontrib><creatorcontrib>Xie, Dawei</creatorcontrib><creatorcontrib>Wang, Xue</creatorcontrib><creatorcontrib>Baudier, Robin L.</creatorcontrib><creatorcontrib>Orlandi, Paula</creatorcontrib><creatorcontrib>Appel, Lawrence J.</creatorcontrib><creatorcontrib>Dember, Laura M.</creatorcontrib><creatorcontrib>He, Jiang</creatorcontrib><creatorcontrib>Kusek, John W.</creatorcontrib><creatorcontrib>Lash, James P.</creatorcontrib><creatorcontrib>Navaneethan, Sankar D.</creatorcontrib><creatorcontrib>Ojo, Akinlolu</creatorcontrib><creatorcontrib>Rahman, Mahboob</creatorcontrib><creatorcontrib>Roy, Jason</creatorcontrib><creatorcontrib>Scialla, Julia J.</creatorcontrib><creatorcontrib>Sondheimer, James H.</creatorcontrib><creatorcontrib>Steigerwalt, Susan P.</creatorcontrib><creatorcontrib>Wilson, F. Perry</creatorcontrib><creatorcontrib>Wolf, Myles</creatorcontrib><creatorcontrib>Feldman, Harold I.</creatorcontrib><creatorcontrib>Go, Alan S.</creatorcontrib><creatorcontrib>Townsend, Raymond R.</creatorcontrib><creatorcontrib>CRIC Study Investigators</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anderson, Amanda H.</au><au>Xie, Dawei</au><au>Wang, Xue</au><au>Baudier, Robin L.</au><au>Orlandi, Paula</au><au>Appel, Lawrence J.</au><au>Dember, Laura M.</au><au>He, Jiang</au><au>Kusek, John W.</au><au>Lash, James P.</au><au>Navaneethan, Sankar D.</au><au>Ojo, Akinlolu</au><au>Rahman, Mahboob</au><au>Roy, Jason</au><au>Scialla, Julia J.</au><au>Sondheimer, James H.</au><au>Steigerwalt, Susan P.</au><au>Wilson, F. Perry</au><au>Wolf, Myles</au><au>Feldman, Harold I.</au><au>Go, Alan S.</au><au>Townsend, Raymond R.</au><aucorp>CRIC Study Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Novel Risk Factors for Progression of Diabetic and Nondiabetic CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>77</volume><issue>1</issue><spage>56</spage><epage>73.e1</epage><pages>56-73.e1</pages><issn>0272-6386</issn><issn>1523-6838</issn><eissn>1523-6838</eissn><abstract>Identification of novel risk factors for chronic kidney disease (CKD) progression may inform mechanistic investigations and improve identification of high-risk subgroups. The current study aimed to characterize CKD progression across levels of numerous risk factors and identify independent risk factors for CKD progression among those with and without diabetes.
The Chronic Renal Insufficiency Cohort (CRIC) Study is a prospective cohort study of adults with CKD conducted at 7 US clinical centers.
Participants (N=3,379) had up to 12.3 years of follow-up; 47% had diabetes.
30 risk factors for CKD progression across sociodemographic, behavioral, clinical, and biochemical domains at baseline.
Study outcomes were estimated glomerular filtration rate (eGFR) slope and the composite of halving of eGFR or initiation of kidney replacement therapy.
Stepwise selection of independent risk factors was performed stratified by diabetes status using linear mixed-effects and Cox proportional hazards models.
Among those without and with diabetes, respectively, mean eGFR slope was−1.4±3.3 and−2.7±4.7mL/min/1.73m2 per year. Among participants with diabetes, multivariable-adjusted hazard of the composite outcome was approximately 2-fold or greater with higher levels of the inflammatory chemokine CXCL12, the cardiac marker N-terminal pro–B-type natriuretic peptide (NT-proBNP), and the kidney injury marker urinary neutrophil gelatinase-associated lipocalin (NGAL). Among those without diabetes, low serum bicarbonate and higher high-sensitivity troponin T, NT-proBNP, and urinary NGAL levels were all significantly associated with a 1.5-fold or greater rate of the composite outcome.
The observational study design precludes causal inference.
Strong associations for cardiac markers, plasma CXCL12, and urinary NGAL are comparable to that of systolic blood pressure≥140mm Hg, a well-established risk factor for CKD progression. This warrants further investigation into the potential mechanisms that these markers indicate and opportunities to use them to improve risk stratification.
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32866540</pmid><doi>10.1053/j.ajkd.2020.07.011</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0272-6386 |
| ispartof | American journal of kidney diseases, 2021-01, Vol.77 (1), p.56-73.e1 |
| issn | 0272-6386 1523-6838 1523-6838 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7752839 |
| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Blood Pressure - physiology Cardiometabolic Risk Factors Chemokine CXCL12 - blood Chronic kidney disease (CKD) CKD progression CXCL12 diabetes Diabetic Nephropathies - diagnosis Diabetic Nephropathies - epidemiology Diabetic Nephropathies - metabolism Diabetic Nephropathies - physiopathology Disease Progression eGFR slope end-stage renal disease (ESRD) estimated glomerular filtration rate (eGFR) Female halving of eGFR Humans inflammatory chemokines kidney replacement therapy (KRT) Life Style Lipocalin-2 - urine Male Middle Aged N-terminal pro-B-type natriuretic peptide (NTproBNP) neutrophil gelatinase-associated lipocalin (NGAL) Prognosis Prospective Studies renal function trajectory Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - metabolism Renal Insufficiency, Chronic - physiopathology Risk Assessment - methods risk stratification Socioeconomic Factors United States - epidemiology |
| title | Novel Risk Factors for Progression of Diabetic and Nondiabetic CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-22T20%3A19%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Novel%20Risk%20Factors%20for%20Progression%20of%20Diabetic%20and%20Nondiabetic%20CKD:%20Findings%20From%20the%20Chronic%20Renal%20Insufficiency%20Cohort%20(CRIC)%20Study&rft.jtitle=American%20journal%20of%20kidney%20diseases&rft.au=Anderson,%20Amanda%20H.&rft.aucorp=CRIC%20Study%20Investigators&rft.date=2021-01-01&rft.volume=77&rft.issue=1&rft.spage=56&rft.epage=73.e1&rft.pages=56-73.e1&rft.issn=0272-6386&rft.eissn=1523-6838&rft_id=info:doi/10.1053/j.ajkd.2020.07.011&rft_dat=%3Cproquest_pubme%3E2439621629%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2439621629&rft_id=info:pmid/32866540&rft_els_id=S0272638620309252&rfr_iscdi=true |