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ABSTRACT: Background
To better understand a potential association of elevated C-reactive protein (CRP) level with progression of chronic kidney disease (CKD), we examined the relationship of CRP level with the development of end-stage renal disease (ESRD) in the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT).Study design
Post hoc analysis of a randomized controlled trial.Setting & participants
4,038 patients with type 2 diabetes, CKD, and anemia in TREAT.Predictor
Baseline serum CRP concentrations.Outcomes
The primary outcome was development of ESRD; secondary outcomes included doubling of serum creatinine level, a composite of ESRD/serum creatinine doubling, and a composite of death or ESRD.Measurements
We fit unadjusted and adjusted Cox regression models to test the association of baseline CRP level with time to the development of the outcomes of interest.Results
Mean age of participants was 67 years, 43% were men, and 64% were white. Approximately half (48%) the patients had CRP levels > 3.0mg/L; 668 patients developed ESRD, and 1,270 developed the composite outcome of death or ESRD. Compared with patients with baseline CRP levels ≤ 3.0mg/L, those with moderately/markedly elevated CRP levels (≥6.9mg/L; 24% of patients) had a higher adjusted risk for ESRD (HR, 1.32; 95% CI, 1.07-1.63) and the composite outcome of death or ESRD (HR, 1.41; 95% CI, 1.21-1.64). Although nonsignificant, similar trends were noted in competing-risk models.Limitations
Results may not be generalizable to nondiabetic CKD or diabetic CKD in the absence of anemia.Conclusions
Elevated baseline CRP levels are common in type 2 diabetic patients with anemia and CKD and are associated with the future development of ESRD and the composite of death or ESRD.
SUBMITTER: Mc Causland FR
PROVIDER: S-EPMC5123931 | biostudies-literature | 2016 Dec
REPOSITORIES: biostudies-literature
Mc Causland Finnian R FR Claggett Brian B Burdmann Emmanuel A EA Eckardt Kai-Uwe KU Kewalramani Reshma R Levey Andrew S AS McMurray John J V JJ Parfrey Patrick P Remuzzi Giuseppe G Singh Ajay K AK Solomon Scott D SD Toto Robert D RD Pfeffer Marc A MA
American journal of kidney diseases : the official journal of the National Kidney Foundation 20160916 6
<h4>Background</h4>To better understand a potential association of elevated C-reactive protein (CRP) level with progression of chronic kidney disease (CKD), we examined the relationship of CRP level with the development of end-stage renal disease (ESRD) in the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT).<h4>Study design</h4>Post hoc analysis of a randomized controlled trial.<h4>Setting & participants</h4>4,038 patients with type 2 diabetes, CKD, and anemia in TREAT.<h4>Pre ...[more]