Association of TNF Receptor 2 and CRP with GFR Decline in the General Nondiabetic Population

Clinical journal of the American Society of Nephrology: CJASN

Jørgen Schei² 

[1] *Metabolic and Renal Research Group and..;*Metabolic and Renal Research Group and..*Metabolic and Renal Research Group and..*Metabolic and Renal Research Group and..*Metabolic and Renal Research Group and..*Metabolic and Renal Research Group and..§Department of Community Medicine, University in Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway

关键词: GFR decline;    chronic kidney disease;    soluble TNF receptors;    Inflammation;    Measured GFR;    cytokines;    aging;    C-Reactive Protein;    Cardiovascular Diseases;    diabetes mellitus;    Follow-Up Studies;    glomerular filtration rate;    TNFRSF1B protein, human;    Humans;    Iohexol, kidney;    Kidney Function Tests;    Logistic Models;    Middle Aged;    Odds Ratio;    Receptors, Tumor Necrosis Factor, Type II;    Renal Insufficiency, Chronic;    Surveys and Questionnaires;   

DOI  :  10.2215/CJN.09280916

学科分类：泌尿医学

来源: American Society of Nephrology

【 摘 要 】

Background and objectives Higher levels of inflammatory markers have been associated with renal outcomes in diabetic populations. We investigated whether soluble TNF receptor 2 (TNFR2) and high-sensitivity C-reactive protein (hsCRP) were associated with the age-related GFR decline in a nondiabetic population using measured GFR (mGFR).Design, setting, participants, & measurements A representative sample of 1590 middle-aged people from the general population without prevalent kidney disease, diabetes, or cardiovascular disease were enrolled in the Renal Iohexol-Clearance Survey in Tromsø 6 (RENIS-T6) between 2007 and 2009. After a median of 5.6 years, 1296 persons were included in the Renal Iohexol-Clearance Survey Follow-Up Study. GFR was measured using iohexol clearance at baseline and follow-up.Results The mean decline of mGFR during the period was −0.84 ml/min per 1.73 m2 per year. There were 133 participants with rapid mGFR decline, defined as an annual mGFR loss >3.0 ml/min per 1.73 m2, and 26 participants with incident CKD, defined as mGFR<60 ml/min per 1.73 m2 at follow-up. In multivariable adjusted mixed models, 1 mg/L higher levels of hsCRP were associated with an accelerated decline in mGFR of −0.03 ml/min per 1.73 m2 per year (95% confidence interval [95% CI], −0.05 to −0.01), and 1 SD higher TNFR2 was associated with a slower decline in mGFR (0.09 ml/min per 1.73 m2 per year; 95% CI, 0.01 to 0.18). In logistic regression models adjusted for sex, age, weight, and height, 1 mg/L higher levels of hsCRP were associated with higher risk of rapid mGFR decline (odds ratio, 1.03; 95% CI, 1.01 to 1.06) and incident CKD (odds ratio, 1.04; 95% CI, 1.00 to 1.08).Conclusions Higher baseline levels of hsCRP but not TNFR2 were associated with accelerated age-related mGFR decline and incident CKD in a general nondiabetic population.

【 授权许可】

CC BY