Elizabeth L M Barr1,2, Federica Barzi3, Jaquelyne T Hughes3,4, George Jerums5,6, Wendy E Hoy7, Kerin O'Dea3,8, Graham R D Jones9,10, Paul D Lawton3, Alex D H Brown11,12, Mark Thomas13, Elif I Ekinci3,5,6, Ashim Sinha14, Alan Cass3, Richard J MacIsaac6,15, Louise J Maple-Brown3,4. 1. Menzies School of Health Research, Darwin, Northern Territory, Australia elizabeth.barr@menzies.edu.au. 2. Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia. 3. Menzies School of Health Research, Darwin, Northern Territory, Australia. 4. Royal Darwin Hospital, Darwin, Northern Territory, Australia. 5. Department of Endocrinology, Austin Health, Melbourne, Victoria, Australia. 6. Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia. 7. The University of Queensland, Brisbane, Queensland, Australia. 8. Nutrition and Population Health, University of South Australia, Adelaide, South Australia, Australia. 9. SydPath, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia. 10. Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia. 11. Aboriginal Health, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia. 12. Indigenous Health, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. 13. Royal Perth Hospital, Perth, Western Australia, Australia. 14. Diabetes and Endocrinology, Cairns Base Hospital, Cairns, Queensland, Australia. 15. Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
Abstract
OBJECTIVE: To examine the association between soluble tumor necrosis factor receptor 1 (sTNFR1) levels and kidney disease progression in Indigenous Australians at high risk of kidney disease. RESEARCH DESIGN AND METHODS: This longitudinal observational study examined participants aged ≥18 years recruited from >20 sites across diabetes and/or kidney function strata. Baseline measures included sTNFR1, serum creatinine, urine albumin-to-creatinine ratio (uACR), HbA1c, C-reactive protein (CRP), waist-to-hip ratio, systolic blood pressure, and medical history. Linear regression was used to estimate annual change in estimated glomerular filtration rate (eGFR) for increasing sTNFR1, and Cox proportional hazards were used to estimate the hazard ratio (HR) and 95% CI for developing a combined renal outcome (first of a ≥30% decline in eGFR with a follow-up eGFR <60 mL/min/1.73 m2, progression to renal replacement therapy, or renal death) for increasing sTNFR1. RESULTS: Over a median of 3 years, participants with diabetes (n = 194) in the highest compared with the lowest quartile of sTNFR1 experienced significantly greater eGFR decline (-4.22 mL/min/1.73 m2/year [95% CI -7.06 to -1.38]; P = 0.004), independent of baseline age, sex, eGFR, and uACR. The adjusted HR (95% CI) for participants with diabetes per doubling of sTNFR1 for the combined renal outcome (n = 32) was 3.8 (1.1-12.8; P = 0.03). No association between sTNFR1 and either renal outcome was observed for those without diabetes (n = 259). CONCLUSIONS: sTNFR1 is associated with greater kidney disease progression independent of albuminuria and eGFR in Indigenous Australians with diabetes. Further research is required to assess whether TNFR1 operates independently of other metabolic factors associated with kidney disease progression.
OBJECTIVE: To examine the association between soluble tumor necrosis factor receptor 1 (sTNFR1) levels and kidney disease progression in Indigenous Australians at high risk of kidney disease. RESEARCH DESIGN AND METHODS: This longitudinal observational study examined participants aged ≥18 years recruited from >20 sites across diabetes and/or kidney function strata. Baseline measures included sTNFR1, serum creatinine, urine albumin-to-creatinine ratio (uACR), HbA1c, C-reactive protein (CRP), waist-to-hip ratio, systolic blood pressure, and medical history. Linear regression was used to estimate annual change in estimated glomerular filtration rate (eGFR) for increasing sTNFR1, and Cox proportional hazards were used to estimate the hazard ratio (HR) and 95% CI for developing a combined renal outcome (first of a ≥30% decline in eGFR with a follow-up eGFR <60 mL/min/1.73 m2, progression to renal replacement therapy, or renal death) for increasing sTNFR1. RESULTS: Over a median of 3 years, participants with diabetes (n = 194) in the highest compared with the lowest quartile of sTNFR1 experienced significantly greater eGFR decline (-4.22 mL/min/1.73 m2/year [95% CI -7.06 to -1.38]; P = 0.004), independent of baseline age, sex, eGFR, and uACR. The adjusted HR (95% CI) for participants with diabetes per doubling of sTNFR1 for the combined renal outcome (n = 32) was 3.8 (1.1-12.8; P = 0.03). No association between sTNFR1 and either renal outcome was observed for those without diabetes (n = 259). CONCLUSIONS: sTNFR1 is associated with greater kidney disease progression independent of albuminuria and eGFR in Indigenous Australians with diabetes. Further research is required to assess whether TNFR1 operates independently of other metabolic factors associated with kidney disease progression.
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: Monika A Niewczas; Meda E Pavkov; Jan Skupien; Adam Smiles; Zaipul I Md Dom; Jonathan M Wilson; Jihwan Park; Viji Nair; Andrew Schlafly; Pierre-Jean Saulnier; Eiichiro Satake; Christopher A Simeone; Hetal Shah; Chengxiang Qiu; Helen C Looker; Paolo Fiorina; Carl F Ware; Jennifer K Sun; Alessandro Doria; Matthias Kretzler; Katalin Susztak; Kevin L Duffin; Robert G Nelson; Andrzej S Krolewski Journal: Nat Med Date: 2019-04-22 Impact factor: 53.440
Authors: Richard J MacIsaac; Matthew Farag; Varuni Obeyesekere; Michele Clarke; Ray Boston; Glenn M Ward; George Jerums; Elif I Ekinci Journal: J Diabetes Investig Date: 2019-06-03 Impact factor: 4.232
Authors: Mary Jo Kurth; William T McBride; Gavin McLean; Joanne Watt; Anna Domanska; John V Lamont; Daniel Maguire; Peter Fitzgerald; Mark W Ruddock Journal: Sci Rep Date: 2020-11-17 Impact factor: 4.379