Cargando…
Plasma kidney injury molecule-1 (p-KIM-1) levels and deterioration of kidney function over 16 years
BACKGROUND: The kidney injury molecule-1 (KIM-1) has previously been associated with kidney function in rodents and humans. Yet its role as a predictive marker for future decline in kidney function has remained less clear. METHODS: At baseline (1991–1994), fasting plasma KIM-1 (p-KIM-1) was measured...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049260/ https://www.ncbi.nlm.nih.gov/pubmed/30629206 http://dx.doi.org/10.1093/ndt/gfy382 |
_version_ | 1783502405292261376 |
---|---|
author | Schulz, Christina-Alexandra Engström, Gunnar Nilsson, Jan Almgren, Peter Petkovic, Marinka Christensson, Anders Nilsson, Peter M Melander, Olle Orho-Melander, Marju |
author_facet | Schulz, Christina-Alexandra Engström, Gunnar Nilsson, Jan Almgren, Peter Petkovic, Marinka Christensson, Anders Nilsson, Peter M Melander, Olle Orho-Melander, Marju |
author_sort | Schulz, Christina-Alexandra |
collection | PubMed |
description | BACKGROUND: The kidney injury molecule-1 (KIM-1) has previously been associated with kidney function in rodents and humans. Yet its role as a predictive marker for future decline in kidney function has remained less clear. METHODS: At baseline (1991–1994), fasting plasma KIM-1 (p-KIM-1) was measured in 4739 participants of the population-based Malmö Diet and Cancer Study. Creatinine and cystatin C were used to calculate estimated glomerular filtration rate (eGFR) according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Collaboration 2012 creatinine–cystatin C equation at baseline and follow-up examination (2007–2012). Incident CKD was defined as an eGFR <60 mL/min/1.73 m(2) at follow-up. RESULTS: During a mean follow-up time of 16.6 years, high p-KIM-1 levels were associated with a greater decline in eGFR (quartile 1 −1.36 versus quartile 4 −1.54 mL/min/1.73 m(2); P < 0.001). In multivariate analyses, the risk for incident CKD at the follow-up examination was higher among participants with baseline p-KIM-1 levels in the highest quartile {odds ratio [OR] 1.45 [95% confidence interval (CI) 1.10–1.92]} compared with those within the lowest quartile. The relative impact of baseline p-KIM-1 on incidence of CKD [OR 1.20 (95% CI 1.08–1.33) per 1 standard deviation (SD) increase in p-KIM-1] was comparable to those of age and systolic blood pressure (SBP) [OR 1.55 (95% CI 1.38–1.74) and OR 1.21 (95% CI 1.09–1.35) per 1 SD increase, respectively]. Adding p-KIM-1 to a conventional risk model resulted in significantly improved C-statistics (P = 0.04) and reclassified 9% of the individuals into the correct risk direction (continuous net reclassification improvement P = 0.02). Furthermore, the risk for hospitalization due to impaired renal function increased with increasing baseline p-KIM-1 [hazard ratio per 1 SD 1.43; (95% CI 1.18–1.74)] during a mean follow-up time of 19.2 years. CONCLUSION: Our results show that p-KIM-1 predicts the future decline of eGFR and risk of CKD in healthy middle-aged participants. Whether p-KIM-1 can be used to prioritize preventive action that needs to be further investigated. |
format | Online Article Text |
id | pubmed-7049260 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-70492602020-03-04 Plasma kidney injury molecule-1 (p-KIM-1) levels and deterioration of kidney function over 16 years Schulz, Christina-Alexandra Engström, Gunnar Nilsson, Jan Almgren, Peter Petkovic, Marinka Christensson, Anders Nilsson, Peter M Melander, Olle Orho-Melander, Marju Nephrol Dial Transplant ORIGINAL ARTICLES BACKGROUND: The kidney injury molecule-1 (KIM-1) has previously been associated with kidney function in rodents and humans. Yet its role as a predictive marker for future decline in kidney function has remained less clear. METHODS: At baseline (1991–1994), fasting plasma KIM-1 (p-KIM-1) was measured in 4739 participants of the population-based Malmö Diet and Cancer Study. Creatinine and cystatin C were used to calculate estimated glomerular filtration rate (eGFR) according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Collaboration 2012 creatinine–cystatin C equation at baseline and follow-up examination (2007–2012). Incident CKD was defined as an eGFR <60 mL/min/1.73 m(2) at follow-up. RESULTS: During a mean follow-up time of 16.6 years, high p-KIM-1 levels were associated with a greater decline in eGFR (quartile 1 −1.36 versus quartile 4 −1.54 mL/min/1.73 m(2); P < 0.001). In multivariate analyses, the risk for incident CKD at the follow-up examination was higher among participants with baseline p-KIM-1 levels in the highest quartile {odds ratio [OR] 1.45 [95% confidence interval (CI) 1.10–1.92]} compared with those within the lowest quartile. The relative impact of baseline p-KIM-1 on incidence of CKD [OR 1.20 (95% CI 1.08–1.33) per 1 standard deviation (SD) increase in p-KIM-1] was comparable to those of age and systolic blood pressure (SBP) [OR 1.55 (95% CI 1.38–1.74) and OR 1.21 (95% CI 1.09–1.35) per 1 SD increase, respectively]. Adding p-KIM-1 to a conventional risk model resulted in significantly improved C-statistics (P = 0.04) and reclassified 9% of the individuals into the correct risk direction (continuous net reclassification improvement P = 0.02). Furthermore, the risk for hospitalization due to impaired renal function increased with increasing baseline p-KIM-1 [hazard ratio per 1 SD 1.43; (95% CI 1.18–1.74)] during a mean follow-up time of 19.2 years. CONCLUSION: Our results show that p-KIM-1 predicts the future decline of eGFR and risk of CKD in healthy middle-aged participants. Whether p-KIM-1 can be used to prioritize preventive action that needs to be further investigated. Oxford University Press 2020-02 2019-01-09 /pmc/articles/PMC7049260/ /pubmed/30629206 http://dx.doi.org/10.1093/ndt/gfy382 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | ORIGINAL ARTICLES Schulz, Christina-Alexandra Engström, Gunnar Nilsson, Jan Almgren, Peter Petkovic, Marinka Christensson, Anders Nilsson, Peter M Melander, Olle Orho-Melander, Marju Plasma kidney injury molecule-1 (p-KIM-1) levels and deterioration of kidney function over 16 years |
title | Plasma kidney injury molecule-1 (p-KIM-1) levels and deterioration of kidney function over 16 years |
title_full | Plasma kidney injury molecule-1 (p-KIM-1) levels and deterioration of kidney function over 16 years |
title_fullStr | Plasma kidney injury molecule-1 (p-KIM-1) levels and deterioration of kidney function over 16 years |
title_full_unstemmed | Plasma kidney injury molecule-1 (p-KIM-1) levels and deterioration of kidney function over 16 years |
title_short | Plasma kidney injury molecule-1 (p-KIM-1) levels and deterioration of kidney function over 16 years |
title_sort | plasma kidney injury molecule-1 (p-kim-1) levels and deterioration of kidney function over 16 years |
topic | ORIGINAL ARTICLES |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049260/ https://www.ncbi.nlm.nih.gov/pubmed/30629206 http://dx.doi.org/10.1093/ndt/gfy382 |
work_keys_str_mv | AT schulzchristinaalexandra plasmakidneyinjurymolecule1pkim1levelsanddeteriorationofkidneyfunctionover16years AT engstromgunnar plasmakidneyinjurymolecule1pkim1levelsanddeteriorationofkidneyfunctionover16years AT nilssonjan plasmakidneyinjurymolecule1pkim1levelsanddeteriorationofkidneyfunctionover16years AT almgrenpeter plasmakidneyinjurymolecule1pkim1levelsanddeteriorationofkidneyfunctionover16years AT petkovicmarinka plasmakidneyinjurymolecule1pkim1levelsanddeteriorationofkidneyfunctionover16years AT christenssonanders plasmakidneyinjurymolecule1pkim1levelsanddeteriorationofkidneyfunctionover16years AT nilssonpeterm plasmakidneyinjurymolecule1pkim1levelsanddeteriorationofkidneyfunctionover16years AT melanderolle plasmakidneyinjurymolecule1pkim1levelsanddeteriorationofkidneyfunctionover16years AT orhomelandermarju plasmakidneyinjurymolecule1pkim1levelsanddeteriorationofkidneyfunctionover16years |