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Association between levels of pentraxin 3 and incidence of chronic kidney disease in the elderly
Author(s) -
Sjöberg B.,
Qureshi A. R.,
Heimbürger O.,
Stenvinkel P.,
Lind L.,
Larsson A.,
Bárány P.,
Ärnlöv J.
Publication year - 2016
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/joim.12411
Subject(s) - medicine , renal function , kidney disease , cystatin c , albuminuria , creatinine , odds ratio , confidence interval , prospective cohort study , incidence (geometry) , endocrinology , gastroenterology , physics , optics
Abstract Objective Higher levels of the novel inflammatory marker pentraxin 3 ( PTX 3) predict cardiovascular mortality in patients with chronic kidney disease ( CKD ). Yet, whether PTX 3 predicts worsening of kidney function has been less well studied. We therefore investigated the associations between PTX 3 levels, kidney disease measures and CKD incidence. Methods Cross‐sectional associations between serum PTX 3 levels, urinary albumin/creatinine ratio ( ACR ) and cystatin C‐estimated glomerular filtration rate ( GFR ) were assessed in two independent community‐based cohorts of elderly subjects: the Prospective Investigation of the Vasculature in Uppsala Seniors ( PIVUS , n = 768, 51% women, mean age 75 years) and the Uppsala Longitudinal Study of Adult Men ( ULSAM , n = 651, mean age 77 years). The longitudinal association between PTX 3 level at baseline and incident CKD ( GFR <60 mL min −1 1.73 m − ²) was also analysed (number of events/number at risk: PIVUS 229/746, ULSAM 206/315). Results PTX 3 levels were inversely associated with GFR [ PIVUS : B‐coefficient per 1 SD increase −0.16, 95% confidence interval ( CI ) −0.23 to −0.10, P < 0.001; ULSAM : B‐coefficient per 1 SD increase −0.09, 95% CI −0.16 to −0.01, P < 0.05], but not ACR , after adjusting for age, gender, C‐reactive protein and prevalent cardiovascular disease in cross‐sectional analyses. In longitudinal analyses, PTX 3 levels predicted incident CKD after 5 years in both cohorts [ PIVUS : multivariable odds ratio ( OR ) 1.21, 95% CI 1.01–1.45, P < 0.05; ULSAM : multivariable OR 1.37, 95% CI 1.07–1.77, P < 0.05]. Conclusions Higher PTX 3 levels are associated with lower GFR and independently predict incident CKD in elderly men and women. Our data confirm and extend previous evidence suggesting that inflammatory processes are activated in the early stages of CKD and drive impairment of kidney function. Circulating PTX 3 appears to be a promising biomarker of kidney disease.