OBJECTIVE: Renal dysfunction is a key risk factor for all-cause mortality in patients with type 2 diabetes (T2D). Circulating tumor necrosis factor receptor 1 (TNFR1) was recently suggested as a strong biomarker for end-stage renal failure in T2D. However, its relevance regarding all-cause death has yet to be conclusively established. We aimed to assess the prognostic value of serum TNFR1 concentration for all-cause death in T2D and diabetic kidney disease (DKD) from the SURDIAGENE (Survie, Diabete de type 2 et Genetique) study. RESEARCH DESIGN AND METHODS: A total of 522 T2D patients with DKD (estimated glomerular filtration rate [eGFR] <60 and/or urinary albumin-to-creatinine ratio [uACR] >30 mg/mmol) were followed for a median duration of 48 months, and 196 deaths occurred. RESULTS: Incidence rate (95% CI) for death increased as quartiles of TNFR1 concentration increased (first quartile: 4.7% patient-years [3.0-6.3%]; second quartile: 7.7% [5.4-10.0%]; third quartile: 9.3% [6.7-11.9%]; fourth quartile: 15.9% [12.2-19.5%]). In multivariate analysis taking age, diabetes duration, HbA1c, uACR, and eGFR into account, compared with the first quartile, patients from the fourth quartile had an adjusted hazard ratio for death of 2.98 (95% CI 1.70-5.23). The integrated discrimination improvement index was statistically significant when adding TNFR1 concentration to the UK Prospective Diabetes Study outcome equation (P = 0.031). CONCLUSIONS: TNFR1 is a strong prognostic factor for all-cause mortality in T2D with renal dysfunction, and its clinical utility is suggested in addition to established risk factors for all-cause mortality.
OBJECTIVE:Renal dysfunction is a key risk factor for all-cause mortality in patients with type 2 diabetes (T2D). Circulating tumor necrosis factor receptor 1 (TNFR1) was recently suggested as a strong biomarker for end-stage renal failure in T2D. However, its relevance regarding all-cause death has yet to be conclusively established. We aimed to assess the prognostic value of serum TNFR1 concentration for all-cause death in T2D and diabetic kidney disease (DKD) from the SURDIAGENE (Survie, Diabete de type 2 et Genetique) study. RESEARCH DESIGN AND METHODS: A total of 522 T2D patients with DKD (estimated glomerular filtration rate [eGFR] <60 and/or urinary albumin-to-creatinine ratio [uACR] >30 mg/mmol) were followed for a median duration of 48 months, and 196 deaths occurred. RESULTS: Incidence rate (95% CI) for death increased as quartiles of TNFR1 concentration increased (first quartile: 4.7% patient-years [3.0-6.3%]; second quartile: 7.7% [5.4-10.0%]; third quartile: 9.3% [6.7-11.9%]; fourth quartile: 15.9% [12.2-19.5%]). In multivariate analysis taking age, diabetes duration, HbA1c, uACR, and eGFR into account, compared with the first quartile, patients from the fourth quartile had an adjusted hazard ratio for death of 2.98 (95% CI 1.70-5.23). The integrated discrimination improvement index was statistically significant when adding TNFR1 concentration to the UK Prospective Diabetes Study outcome equation (P = 0.031). CONCLUSIONS:TNFR1 is a strong prognostic factor for all-cause mortality in T2D with renal dysfunction, and its clinical utility is suggested in addition to established risk factors for all-cause mortality.
Authors: Katsuhito Ihara; Jan Skupien; Bozena Krolewski; Zaipul I Md Dom; Kristina O'Neil; Eiichiro Satake; Hiroki Kobayashi; Narges M Rashidi; Monika A Niewczas; Andrzej S Krolewski Journal: Kidney Int Date: 2020-07-25 Impact factor: 10.612
Authors: Axel C Carlsson; Juan-Jesús Carrero; Peter Stenvinkel; Matteo Bottai; Peter Barany; Anders Larsson; Johan Ärnlöv Journal: Cardiorenal Med Date: 2015-01-30 Impact factor: 2.041
Authors: Steven Menez; Dennis G Moledina; Amit X Garg; Heather Thiessen-Philbrook; Eric McArthur; Yaqi Jia; Caroline Liu; Wassim Obeid; Sherry G Mansour; Jay L Koyner; Michael G Shlipak; Francis P Wilson; Steven G Coca; Chirag R Parikh Journal: Kidney Int Date: 2020-07-25 Impact factor: 10.612
Authors: Andreas Heinzel; Michael Kammer; Gert Mayer; Roman Reindl-Schwaighofer; Karin Hu; Paul Perco; Susanne Eder; Laszlo Rosivall; Patrick B Mark; Wenjun Ju; Matthias Kretzler; Peter Gilmour; Jonathan M Wilson; Kevin L Duffin; Moustafa Abdalla; Mark I McCarthy; Georg Heinze; Hiddo L Heerspink; Andrzej Wiecek; Maria F Gomez; Rainer Oberbauer Journal: Diabetes Care Date: 2018-07-06 Impact factor: 19.112