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Associations between urinary kidney injury biomarkers and cardiovascular mortality risk in elderly men with diabetes
AIM: Three urinary biomarkers, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and cystatin C, have been suggested as clinically relevant highly specific biomarkers of acute kidney tubular damage. Yet, the utility of these biomarkers in the prognostication of dia...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967263/ https://www.ncbi.nlm.nih.gov/pubmed/27321055 http://dx.doi.org/10.1080/03009734.2016.1192704 |
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author | Tonkonogi, Aleksandra Carlsson, Axel C. Helmersson-Karlqvist, Johanna Larsson, Anders Ärnlöv, Johan |
author_facet | Tonkonogi, Aleksandra Carlsson, Axel C. Helmersson-Karlqvist, Johanna Larsson, Anders Ärnlöv, Johan |
author_sort | Tonkonogi, Aleksandra |
collection | PubMed |
description | AIM: Three urinary biomarkers, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and cystatin C, have been suggested as clinically relevant highly specific biomarkers of acute kidney tubular damage. Yet, the utility of these biomarkers in the prognostication of diabetic nephropathy has been less studied. Therefore, we aimed to investigate the longitudinal association between these urinary biomarkers and cardiovascular mortality in patients with diabetes. METHODS: The study sample consisted of participants with diabetes in the community-based Uppsala Longitudinal Study of Adult Men (n = 91; mean age 77.8 years). During follow-up (median 8.3 years, interval 0.7–13.4 years), 33 participants died of cardiovascular causes. RESULTS: In a multivariable Cox regression model adjusting for age, glomerular filtration rate, and urinary albumin/creatinine ratio, higher urinary KIM-1/creatinine was associated with an increased risk for cardiovascular mortality (HR per SD increase 1.51, 95% confidence intervals 1.03–2.24, P = 0.03). Neither urinary NGAL/creatinine nor urinary cystatin C/creatinine were independently associated with an increased cardiovascular mortality risk. CONCLUSION: In elderly men with diabetes, higher urinary KIM-1/creatinine was associated with an increased long-term risk of cardiovascular mortality independently of established markers of diabetic nephropathy. Our data provide support for kidney tubular damage as an important aspect of diabetic nephropathy that merits further investigation. |
format | Online Article Text |
id | pubmed-4967263 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-49672632016-08-25 Associations between urinary kidney injury biomarkers and cardiovascular mortality risk in elderly men with diabetes Tonkonogi, Aleksandra Carlsson, Axel C. Helmersson-Karlqvist, Johanna Larsson, Anders Ärnlöv, Johan Ups J Med Sci Original Articles AIM: Three urinary biomarkers, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and cystatin C, have been suggested as clinically relevant highly specific biomarkers of acute kidney tubular damage. Yet, the utility of these biomarkers in the prognostication of diabetic nephropathy has been less studied. Therefore, we aimed to investigate the longitudinal association between these urinary biomarkers and cardiovascular mortality in patients with diabetes. METHODS: The study sample consisted of participants with diabetes in the community-based Uppsala Longitudinal Study of Adult Men (n = 91; mean age 77.8 years). During follow-up (median 8.3 years, interval 0.7–13.4 years), 33 participants died of cardiovascular causes. RESULTS: In a multivariable Cox regression model adjusting for age, glomerular filtration rate, and urinary albumin/creatinine ratio, higher urinary KIM-1/creatinine was associated with an increased risk for cardiovascular mortality (HR per SD increase 1.51, 95% confidence intervals 1.03–2.24, P = 0.03). Neither urinary NGAL/creatinine nor urinary cystatin C/creatinine were independently associated with an increased cardiovascular mortality risk. CONCLUSION: In elderly men with diabetes, higher urinary KIM-1/creatinine was associated with an increased long-term risk of cardiovascular mortality independently of established markers of diabetic nephropathy. Our data provide support for kidney tubular damage as an important aspect of diabetic nephropathy that merits further investigation. Taylor & Francis 2016-08 2016-06-17 /pmc/articles/PMC4967263/ /pubmed/27321055 http://dx.doi.org/10.1080/03009734.2016.1192704 Text en © 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Tonkonogi, Aleksandra Carlsson, Axel C. Helmersson-Karlqvist, Johanna Larsson, Anders Ärnlöv, Johan Associations between urinary kidney injury biomarkers and cardiovascular mortality risk in elderly men with diabetes |
title | Associations between urinary kidney injury biomarkers and cardiovascular mortality risk in elderly men with diabetes |
title_full | Associations between urinary kidney injury biomarkers and cardiovascular mortality risk in elderly men with diabetes |
title_fullStr | Associations between urinary kidney injury biomarkers and cardiovascular mortality risk in elderly men with diabetes |
title_full_unstemmed | Associations between urinary kidney injury biomarkers and cardiovascular mortality risk in elderly men with diabetes |
title_short | Associations between urinary kidney injury biomarkers and cardiovascular mortality risk in elderly men with diabetes |
title_sort | associations between urinary kidney injury biomarkers and cardiovascular mortality risk in elderly men with diabetes |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967263/ https://www.ncbi.nlm.nih.gov/pubmed/27321055 http://dx.doi.org/10.1080/03009734.2016.1192704 |
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