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Circulating TNF receptors predict cardiovascular disease in patients with chronic kidney disease.

ABSTRACT: Cardiovascular disease (CVD) is the main public health problem in patients with chronic kidney disease (CKD); however, there is no established biomarker for predicting CVD morbidity and mortality in CKD. The aim of this study was to evaluate the role of circulating tumor necrosis factor receptors (cTNFRs) in predicting CVD risk in CKD patients.We prospectively recruited 984 patients with CKD from 11 centers between 2006 and 2012. The levels of cTNFR1 and cTNFR2 were determined by performing an enzyme-linked immunosorbent assay. During the mean follow-up period of 4 years, 36 patients experienced a CVD event. The median serum concentrations of cTNFR1 and cTNFR2 were 2703.4 (225.6-13,057.7) and 5661.0 (634.9-30,599.6)?pg/mL, respectively, and the cTNFR1 level was closely correlated with the cTNFR2 level (r?=?0.86, P?

SUBMITTER: Bae E

PROVIDER: S-EPMC5428576 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Circulating TNF receptors predict cardiovascular disease in patients with chronic kidney disease.

Bae Eunjin E Cha Ran-Hui RH Kim Yong C YC An Jung N JN Kim Dong K DK Yoo Kyung D KD Lee Su M SM Kim Myoung-Hee MH Park Jung T JT Kang Shin-Wook SW Park Jae Y JY Lim Chun S CS Kim Yon S YS Yang Seung H SH Lee Jung P JP

Medicine 20170501 19

Cardiovascular disease (CVD) is the main public health problem in patients with chronic kidney disease (CKD); however, there is no established biomarker for predicting CVD morbidity and mortality in CKD. The aim of this study was to evaluate the role of circulating tumor necrosis factor receptors (cTNFRs) in predicting CVD risk in CKD patients.We prospectively recruited 984 patients with CKD from 11 centers between 2006 and 2012. The levels of cTNFR1 and cTNFR2 were determined by performing an e ...[more]

PMID: 28489742

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Project description:BackgroundPatients with cardiovascular disease are at an increased risk of chronic kidney disease (CKD). However, data on incident CKD in patients with multiple vascular comorbidities are insufficient. In this study, we identified the predictors of CKD stages 3-5 in patients at risk of cardiovascular disease and used their estimated glomerular filtration rate (eGFR) to construct a nomogram to predict the 5-year risk of incident CKD.MethodsAmbulatory data on 622 adults with preserved kidney function and one or more cardiovascular disease risk factors who attended outpatient clinics at a tertiary care hospital in Al-Ain, United Arab Emirates were obtained retrospectively. eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation and assessed every 3?months from baseline to December 12, 2017. Fine and Gray competing risk regression model was used to identify the independent variables and construct a nomogram to predict incident CKD at 5?years, which is defined as eGFR <?60?mL/min/1.73?m2 for ?3?months. Time-dependent area under the receiver operating characteristic curve (AUC) was used to evaluate the discrimination ability of the model. Calibration curves were applied to determine the calibration ability and adjusted for the competing risk of death. Internal validation of predictive accuracy was performed using K-fold cross-validation.ResultsOf the 622 patients, 71 had newly developed CKD stages 3-5 over a median follow-up of 96?months (interquartile range, 86-103?months). Baseline eGFR, hemoglobin A1c, total cholesterol, and history of diabetes mellitus were identified as significant predictors of CKD stages 3-5. The nomogram had good discrimination in predicting the disease stages, with a time-dependent AUC of 0.918 (95% confidence interval, 0.846-0.964) at 5?years, after internal validation by cross-validation.ConclusionsThis study demonstrated that incident CKD could be predicted with a simple and practical nomogram in patients at risk of cardiovascular disease and with preserved kidney function, which in turn could help clinicians make more informed decisions for CKD management in these patients.

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Circulating TNF receptors predict cardiovascular disease in patients with chronic kidney disease.

Publications

Circulating TNF receptors predict cardiovascular disease in patients with chronic kidney disease.

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