Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb 9;2(3):425-432.
doi: 10.1016/j.ekir.2017.02.001. eCollection 2017 May.

Cardiovascular Disease Biomarkers and suPAR in Predicting Decline in Renal Function: A Prospective Cohort Study

Salim S Hayek  1 , Yi-An Ko  1   2 , Mosaab Awad  1 , Hina Ahmed  1 , Brandon Gray  1 , Kareem Mohammed Hosny  1 , Hiroshi Aida  1 , Melissa J Tracy  3 , Changli Wei  3 , Sanja Sever  4 , Jochen Reiser  3 , Arshed A Quyyumi  1
Affiliations

Cardiovascular Disease Biomarkers and suPAR in Predicting Decline in Renal Function: A Prospective Cohort Study

Salim S Hayek et al. Kidney Int Rep. .

Abstract

Introduction: Soluble urokinase-type plasminogen activator receptor (suPAR) strongly predicts outcomes and incident chronic kidney disease (CKD) in patients with cardiovascular disease (CVD). Whether the association between suPAR and CKD is a reflection of its overall association with chronic inflammation and poor CVD outcomes is unclear. We examined whether CVD biomarkers, including high-sensitivity C-reactive protein (hs-CRP), fibrin-degradation products (FDPs), heat-shock protein 70 (HSP-70), and high-sensitivity troponin I (hs-TnI) were associated with a decline in kidney function in the Emory Cardiovascular Biobank cohort, in which suPAR levels were shown to be predictive of both incident CKD and CVD outcomes.

Methods: We measured suPAR, hs-CRP, HSP-70, FDP, and hs-TnI plasma levels in 3282 adults (mean age 63 years, 64% male, 75% estimated glomerular filtration rate [eGFR] >60 ml/min per 1.73 m2). Glomerular filtration rate was estimated using Chronic Kidney Disease-Epidemiology Collaboration (eGFR) at enrollment (n = 3282) and follow-up (n = 2672; median 3.5 years). Urine protein by dipstick at baseline was available for 1335 subjects.

Results: There was a weak correlation among biomarkers (r range: 0.17-0.28). hs-CRP, FDPs, hs-TnI, and suPAR were independently associated with baseline eGFR and proteinuria. The median yearly decline in eGFR was -0.6 ml/min per 1.73 m2. hs-CRP (β: -0.04; P = 0.46), FDPs (β: -0.13; P = 0.08), HSP-70 (β: 0.05; P = 0.84), or hs-TnI (β: -0.01; P = 0.76) were associated with eGFR decline. suPAR remained predictive of eGFR decline even after adjusting for all biomarkers.

Discussion: hs-CRP, FDP, HSP-70, and hs-TnI were not associated with eGFR decline. The specific association of suPAR with eGFR decline supported its involvement in pathways specific to the pathogenesis of kidney disease.

Keywords: CKD; CRP; FDP; HSP-70; creatinine; eGFR; proteinuria; troponin; urokinase.

PubMed Disclaimer

References

    1. Mozaffarian D., Benjamin E.J., Go A.S. Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association. Circulation. 2015 - PubMed
    1. Gansevoort R.T., Correa-Rotter R., Hemmelgarn B.R. Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention. Lancet. 2013;382:339–352. - PubMed
    1. Fassett R.G., Venuthurupalli S.K., Gobe G.C. Biomarkers in chronic kidney disease: a review. Kidney Int. 2011;80:806–821. - PubMed
    1. Levey A.S., Cattran D., Friedman A. Proteinuria as a surrogate outcome in CKD: report of a scientific workshop sponsored by the National Kidney Foundation and the US Food and Drug Administration. Am J Kidney Dis. 2009;54:205–226. - PubMed
    1. James M.T., Hemmelgarn B.R., Tonelli M. Early recognition and prevention of chronic kidney disease. Lancet. 2010;375:1296–1309. - PubMed