期刊
AMERICAN JOURNAL OF NEPHROLOGY
卷 51, 期 10, 页码 797-805出版社
KARGER
DOI: 10.1159/000509978
关键词
Urinary biomarkers; Uromodulin; beta 2-microglobulin; alpha 1-microglobulin; Chronic kidney disease
资金
- NIDDK [K23DK109868, K23DK114556, R01DK098234, K24DK110427]
- American Heart Association [14EIA18560026]
- National Institutes of Health (NIH)
- National Heart, Lung, and Blood Institute (NHLBI)
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- National Institute on Aging (NIA)
- National Institute of Neurological Disorders and Stroke (NINDS) [HHSN268200900040C, HHSN268200900046C, HHSN2682009-00047C, HHSN268200900048C, HHSN268200900049C, A-HL-13-002-001]
- NCATS: CWRU [UL1TR000439]
- NCATS: OSU [UL1RR025755]
- NCATS: U Penn [UL1RR024134, UL1TR000003]
- NCATS: Boston [UL1RR025771]
- NCATS: Stanford [UL1TR000093]
- NCATS: Tufts [UL1RR025752, UL1TR000073, UL1TR001064]
- NCATS: University of Illinois [UL1TR000050]
- NCATS: University of Pittsburgh [UL1TR000005]
- NCATS: UT Southwestern [9U54TR000017-06]
- NCATS: University of Utah [UL1TR000105-05]
- NCATS: Vanderbilt University [UL1 TR000445]
- NCATS: George Washington University [UL1TR000075]
- NCATS: University of CA, Davis [UL1 TR000002]
- NCATS: University of Florida [UL1 TR000064]
- NCATS: University of Michigan [UL1TR000433]
- NCATS: Tulane University [P30GM103337]
- NCATS: Wake Forest University [UL1TR001420]
Background: Kidney tubular atrophy on biopsy is a strong predictor of chronic kidney disease (CKD) progression, but tubular health is poorly quantified by traditional measures including estimated glomerular filtration rate (eGFR) and albuminuria. We hypothesized that urinary biomarkers of impaired tubule function would be associated with faster eGFR declines in persons with CKD. Methods: We measured baseline urine concentrations of uromodulin, beta 2-microglobulin (beta 2m), and alpha 1-microglobulin (alpha 1m) among 2,428 participants of the Systolic Blood Pressure Intervention Trial with an eGFR <60 mL/min/1.73 m(2). We used linear mixed models to evaluate biomarker associations with annualized relative change in eGFR, stratified by randomization arm. Results: At baseline, the mean age was 73 +/- 9 years and eGFR was 46 +/- 11 mL/min/1.73 m(2). In the standard blood pressure treatment arm, each 2-fold higher urinary uromodulin was associated with slower % annual eGFR decline (0.34 [95% CI: 0.08, 0.60]), whereas higher urinary beta 2m was associated with faster % annual eGFR decline (-0.10 [95% CI: -0.18, -0.02]) in multivariable-adjusted models including baseline eGFR and albuminuria. Associations were weaker and did not reach statistical significance in the intensive blood pressure treatment arm for either uromodulin (0.11 [-0.13, 0.35], p value for interaction by treatment arm = 0.045) or beta 2m (-0.01 [-0.08, 0.08], p value for interaction = 0.001). Urinary alpha 1m was not independently associated with eGFR decline in the standard (0.01 [-0.22, 0.23]) or intensive (0.03 [-0.20, 0.25]) arm. Conclusions: Among trial participants with hypertension and CKD, baseline measures of tubular function were associated with subsequent declines in kidney function, although these associations were diminished by intensive blood pressure control. (c) 2020 S. Karger AG, Basel
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据