American journal of kidney diseases : the official journal of the National Kidney Foundation · 2014
Urinary kidney injury molecule 1 (KIM-1) and interleukin 18 (IL-18) as risk markers for heart failure in older adults: the Health, Aging, and Body Composition (Health ABC) Study.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАПоддержка правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Driver Todd H, Katz Ronit, Ix Joachim H, Magnani Jared W, Peralta Carmen A, Parikh Chirag R, Fried Linda, Newman Anne B, Kritchevsky Stephen B, Sarnak Mark J, Shlipak Michael G, Health ABC Study
Аннотация
BACKGROUND: Kidney damage and reduced kidney function are potent risk factors for heart failure, but existing studies are limited to assessing albuminuria or estimated glomerular filtration rate (eGFR). We evaluated the associations of levels of urinary biomarkers of kidney tubular injury (interleukin 18 [IL-18] and kidney injury molecule 1 [KIM-1]) with future risk of heart failure.
STUDY DESIGN: Retrospective cohort study.
SETTING & PARTICIPANTS: 2,917 participants without heart failure in the Health, Aging, and Body Composition (Health ABC) cohort.
PREDICTORS: Ratios of urine KIM-1, IL-18, and albumin to creatinine (KIM-1:Cr, IL-18:Cr, and ACR, respectively).
OUTCOMES: Incident heart failure over a median follow-up of 12 years.
RESULTS: Median values of each marker at baseline were 812 (IQR, 497-1,235)pg/mg for KIM-1:Cr, 31 (IQR, 19-56)pg/mg for IL-18:Cr, and 8 (IQR, 5-19) mg/g for ACR. 596 persons developed heart failure during follow-up. The top quartile of KIM-1:Cr was associated with risk of incident heart failure after adjustment for baseline eGFR, heart failure risk factors, and ACR (HR, 1.32; 95% CI, 1.02-1.70) in adjusted multivariate proportional hazards models. The top quartile of IL-18:Cr also was associated with heart failure in a model adjusted for risk factors and eGFR (HR, 1.35; 95% CI, 1.05-1.73), but was attenuated by adjustment for ACR (HR, 1.15; 95% CI, 0.89-1.48). The top quartile of ACR had a stronger adjusted association with heart failure (HR, 1.96; 95% CI, 1.53-2.51).
LIMITATIONS: Generalizability to other populations is uncertain.
CONCLUSIONS: Higher urine KIM-1 concentrations were associated independently with incident heart failure risk, although the associations of higher ACR were of stronger magnitude.
STUDY DESIGN: Retrospective cohort study.
SETTING & PARTICIPANTS: 2,917 participants without heart failure in the Health, Aging, and Body Composition (Health ABC) cohort.
PREDICTORS: Ratios of urine KIM-1, IL-18, and albumin to creatinine (KIM-1:Cr, IL-18:Cr, and ACR, respectively).
OUTCOMES: Incident heart failure over a median follow-up of 12 years.
RESULTS: Median values of each marker at baseline were 812 (IQR, 497-1,235)pg/mg for KIM-1:Cr, 31 (IQR, 19-56)pg/mg for IL-18:Cr, and 8 (IQR, 5-19) mg/g for ACR. 596 persons developed heart failure during follow-up. The top quartile of KIM-1:Cr was associated with risk of incident heart failure after adjustment for baseline eGFR, heart failure risk factors, and ACR (HR, 1.32; 95% CI, 1.02-1.70) in adjusted multivariate proportional hazards models. The top quartile of IL-18:Cr also was associated with heart failure in a model adjusted for risk factors and eGFR (HR, 1.35; 95% CI, 1.05-1.73), but was attenuated by adjustment for ACR (HR, 1.15; 95% CI, 0.89-1.48). The top quartile of ACR had a stronger adjusted association with heart failure (HR, 1.96; 95% CI, 1.53-2.51).
LIMITATIONS: Generalizability to other populations is uncertain.
CONCLUSIONS: Higher urine KIM-1 concentrations were associated independently with incident heart failure risk, although the associations of higher ACR were of stronger magnitude.
Предметные рубрики MeSH
AgedAgingAlbuminuriaBiomarkersBody CompositionCohort StudiesCreatinineFemaleFollow-Up StudiesHealth StatusHeart FailureHepatitis A Virus Cellular Receptor 1HumansIncidenceInterleukin-18Longitudinal StudiesMaleMembrane GlycoproteinsReceptors, VirusRenal Insufficiency, ChronicRetrospective StudiesRisk Factors