BACKGROUND AND OBJECTIVES: Increased risk of mortality in patients with CKD has been attributed to inflammation. However, the association between kidney function, albuminuria, and biomarkers of inflammation has not been examined in a large cohort of CKD patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This study measured the plasma levels of IL-1β, IL-1 receptor antagonist (IL-1RA), IL-6, TNF-α, TGF-β, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, and serum albumin in 3939 participants enrolled in the Chronic Renal Insufficiency Cohort study between June 2003 and September 2008. An inflammation score was established based on plasma levels of IL-1β, IL-6, TNF-α, hs-CRP, and fibrinogen. Estimated GFR (eGFR) and serum cystatin C were used as measures of kidney function. Albuminuria was quantitated by urine albumin to creatinine ratio (UACR). RESULTS: Plasma levels of IL-1β, IL-1RA, IL-6, TNF-α, hs-CRP, and fibrinogen were higher among participants with lower levels of eGFR. Inflammation score was higher among those with lower eGFR and higher UACR. In regression analysis adjusted for multiple covariates, eGFR, cystatin C, and UACR were strongly associated with fibrinogen, serum albumin, IL-6, and TNF-α. Each unit increase in eGFR, cystatin C, and UACR was associated with a -1.2% (95% confidence interval, -1.4, -1), 64.9% (56.8, 73.3) and 0.6% (0.4, 0.8) change in IL-6, respectively (P<0.001). CONCLUSIONS: Biomarkers of inflammation were inversely associated with measures of kidney function and positively with albuminuria.
BACKGROUND AND OBJECTIVES: Increased risk of mortality in patients with CKD has been attributed to inflammation. However, the association between kidney function, albuminuria, and biomarkers of inflammation has not been examined in a large cohort of CKD patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This study measured the plasma levels of IL-1β, IL-1 receptor antagonist (IL-1RA), IL-6, TNF-α, TGF-β, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, and serum albumin in 3939 participants enrolled in the Chronic Renal Insufficiency Cohort study between June 2003 and September 2008. An inflammation score was established based on plasma levels of IL-1β, IL-6, TNF-α, hs-CRP, and fibrinogen. Estimated GFR (eGFR) and serum cystatin C were used as measures of kidney function. Albuminuria was quantitated by urine albumin to creatinine ratio (UACR). RESULTS: Plasma levels of IL-1β, IL-1RA, IL-6, TNF-α, hs-CRP, and fibrinogen were higher among participants with lower levels of eGFR. Inflammation score was higher among those with lower eGFR and higher UACR. In regression analysis adjusted for multiple covariates, eGFR, cystatin C, and UACR were strongly associated with fibrinogen, serum albumin, IL-6, and TNF-α. Each unit increase in eGFR, cystatin C, and UACR was associated with a -1.2% (95% confidence interval, -1.4, -1), 64.9% (56.8, 73.3) and 0.6% (0.4, 0.8) change in IL-6, respectively (P<0.001). CONCLUSIONS: Biomarkers of inflammation were inversely associated with measures of kidney function and positively with albuminuria.
Authors: Hans L Hillege; Vaclav Fidler; Gilles F H Diercks; Wiek H van Gilst; Dick de Zeeuw; Dirk J van Veldhuisen; Rijk O B Gans; Wilbert M T Janssen; Diederick E Grobbee; Paul E de Jong Journal: Circulation Date: 2002-10-01 Impact factor: 29.690
Authors: Vaidyanathapuram S Balakrishnan; Christopher H Schmid; Bertrand L Jaber; Svetlozar N Natov; Andrew J King; Brian J G Pereira Journal: J Am Soc Nephrol Date: 2000-11 Impact factor: 10.121
Authors: Michael G Shlipak; Linda F Fried; Casey Crump; Anthony J Bleyer; Teri A Manolio; Russell P Tracy; Curt D Furberg; Bruce M Psaty Journal: Circulation Date: 2003-01-07 Impact factor: 29.690
Authors: Harold I Feldman; Lawrence J Appel; Glenn M Chertow; Denise Cifelli; Borut Cizman; John Daugirdas; Jeffrey C Fink; Eunice D Franklin-Becker; Alan S Go; L Lee Hamm; Jiang He; Tom Hostetter; Chi-Yuan Hsu; Kenneth Jamerson; Marshall Joffe; John W Kusek; J Richard Landis; James P Lash; Edgar R Miller; Emile R Mohler; Paul Muntner; Akinlolu O Ojo; Mahboob Rahman; Raymond R Townsend; Jackson T Wright Journal: J Am Soc Nephrol Date: 2003-07 Impact factor: 10.121
Authors: Carmine Zoccali; Raymond Vanholder; Ziad A Massy; Alberto Ortiz; Pantelis Sarafidis; Friedo W Dekker; Danilo Fliser; Denis Fouque; Gunnar H Heine; Kitty J Jager; Mehmet Kanbay; Francesca Mallamaci; Gianfranco Parati; Patrick Rossignol; Andrzej Wiecek; Gerard London Journal: Nat Rev Nephrol Date: 2017-04-24 Impact factor: 28.314
Authors: Daniel E Weiner; Meyeon Park; Hocine Tighiouart; Alin A Joseph; Myra A Carpenter; Nitender Goyal; Andrew A House; Chi-Yuan Hsu; Joachim H Ix; Paul F Jacques; Clifton E Kew; S Joseph Kim; John W Kusek; Todd E Pesavento; Marc A Pfeffer; Stephen R Smith; Matthew R Weir; Andrew S Levey; Andrew G Bostom Journal: Am J Kidney Dis Date: 2018-07-20 Impact factor: 8.860
Authors: Matthew K Abramowitz; William Paredes; Kehao Zhang; Camille R Brightwell; Julia N Newsom; Hyok-Joon Kwon; Matthew Custodio; Rupinder S Buttar; Hina Farooq; Bushra Zaidi; Rima Pai; Jeffrey E Pessin; Meredith Hawkins; Christopher S Fry Journal: Am J Physiol Renal Physiol Date: 2018-10-03