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Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis
BACKGROUND: Defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, chronic kidney disease (CKD) is strongly and independently associated with cardiovascular and overall mortality. We hypothesized that reduced kidney function would be characterized by abnormalities of hemostas...
Autores principales: | , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2011
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3037849/ https://www.ncbi.nlm.nih.gov/pubmed/21269477 http://dx.doi.org/10.1186/1471-2369-12-3 |
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author | Dubin, Ruth Cushman, Mary Folsom, Aaron R Fried, Linda F Palmas, Walter Peralta, Carmen A Wassel, Christina Shlipak, Michael G |
author_facet | Dubin, Ruth Cushman, Mary Folsom, Aaron R Fried, Linda F Palmas, Walter Peralta, Carmen A Wassel, Christina Shlipak, Michael G |
author_sort | Dubin, Ruth |
collection | PubMed |
description | BACKGROUND: Defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, chronic kidney disease (CKD) is strongly and independently associated with cardiovascular and overall mortality. We hypothesized that reduced kidney function would be characterized by abnormalities of hemostasis. METHODS: We tested cross-sectional associations between (eGFR) and multiple hemostatic markers among 6751 participants representing a broad spectrum of kidney function in the Multi-Ethnic Study of Atherosclerosis (MESA). Kidney function was measured using cystatin C (eGFRcys) or creatinine, using CKD Epidemiology Collaboration (eGFRcr). Hemostatic markers included soluble thrombomodulin (sTM), soluble tissue factor (sTF), D-Dimer, von Willebrand factor (vWF), factor VIII, plasmin-antiplasmin complex (PAP), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor-1 (PAI-1), and fibrinogen. Associations were tested using multivariable linear regression with adjustment for demographics and comorbidities. RESULTS: In comparison to persons with eGFRcys >90 ml/min/1.73 m(2), subjects with eGFRcys < 60 ml/min/1.73 m(2 )had adjusted levels of sTM, sTF, D-Dimer, PAP, Factor VIII, TFPI, vWF and fibrinogen that were respectively 86%, 68%, 44%, 22%, 17%, 15%, 12% and 6% higher. Subjects with eGFRcys 60-90 ml/min/1.73 m(2 )had adjusted levels that were respectively 16%, 14%, 12%, 6%, 6%, 6%, 11% and 4% higher (p < 0.05 for all). Percent differences were not significantly different when groups were categorized by eGFRcr. CONCLUSIONS: Throughout a broad spectrum of kidney function, lower eGFR was associated with higher levels of hemostatic markers. Dysregulation of hemostasis may be a mechanism by which reduced kidney function promotes higher cardiovascular risk. |
format | Text |
id | pubmed-3037849 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-30378492011-02-12 Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis Dubin, Ruth Cushman, Mary Folsom, Aaron R Fried, Linda F Palmas, Walter Peralta, Carmen A Wassel, Christina Shlipak, Michael G BMC Nephrol Research Article BACKGROUND: Defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, chronic kidney disease (CKD) is strongly and independently associated with cardiovascular and overall mortality. We hypothesized that reduced kidney function would be characterized by abnormalities of hemostasis. METHODS: We tested cross-sectional associations between (eGFR) and multiple hemostatic markers among 6751 participants representing a broad spectrum of kidney function in the Multi-Ethnic Study of Atherosclerosis (MESA). Kidney function was measured using cystatin C (eGFRcys) or creatinine, using CKD Epidemiology Collaboration (eGFRcr). Hemostatic markers included soluble thrombomodulin (sTM), soluble tissue factor (sTF), D-Dimer, von Willebrand factor (vWF), factor VIII, plasmin-antiplasmin complex (PAP), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor-1 (PAI-1), and fibrinogen. Associations were tested using multivariable linear regression with adjustment for demographics and comorbidities. RESULTS: In comparison to persons with eGFRcys >90 ml/min/1.73 m(2), subjects with eGFRcys < 60 ml/min/1.73 m(2 )had adjusted levels of sTM, sTF, D-Dimer, PAP, Factor VIII, TFPI, vWF and fibrinogen that were respectively 86%, 68%, 44%, 22%, 17%, 15%, 12% and 6% higher. Subjects with eGFRcys 60-90 ml/min/1.73 m(2 )had adjusted levels that were respectively 16%, 14%, 12%, 6%, 6%, 6%, 11% and 4% higher (p < 0.05 for all). Percent differences were not significantly different when groups were categorized by eGFRcr. CONCLUSIONS: Throughout a broad spectrum of kidney function, lower eGFR was associated with higher levels of hemostatic markers. Dysregulation of hemostasis may be a mechanism by which reduced kidney function promotes higher cardiovascular risk. BioMed Central 2011-01-26 /pmc/articles/PMC3037849/ /pubmed/21269477 http://dx.doi.org/10.1186/1471-2369-12-3 Text en Copyright ©2011 Dubin et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Dubin, Ruth Cushman, Mary Folsom, Aaron R Fried, Linda F Palmas, Walter Peralta, Carmen A Wassel, Christina Shlipak, Michael G Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
title | Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
title_full | Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
title_fullStr | Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
title_full_unstemmed | Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
title_short | Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
title_sort | kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3037849/ https://www.ncbi.nlm.nih.gov/pubmed/21269477 http://dx.doi.org/10.1186/1471-2369-12-3 |
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