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Circulating tumour necrosis factor receptors 1 and 2 predict contrast‐induced nephropathy and progressive renal dysfunction: A prospective cohort study
Author(s) -
An Jung Nam,
Yoo Kyung Don,
Hwang Jin Ho,
Kim HackLyoung,
Kim SangHyun,
Yang Seung Hee,
Kim Jin Hyuk,
Kim Dong Ki,
Oh Yun Kyu,
Kim Yon Su,
Lim Chun Soo,
Lee Jung Pyo
Publication year - 2015
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12448
Subject(s) - medicine , renal function , contrast induced nephropathy , percutaneous coronary intervention , kidney disease , creatinine , nephropathy , gastroenterology , prospective cohort study , pathogenesis , biomarker , acute tubular necrosis , coronary artery disease , urology , kidney , diabetes mellitus , myocardial infarction , endocrinology , biochemistry , chemistry
Aim Contrast‐induced nephropathy ( CIN ) is an important cause of hospital‐acquired acute kidney injury. An accurate understanding of the pathogenesis of CIN is crucial. The aim of this study was to evaluate the clinical role of circulating tumour necrosis factor receptors ( cTNFRs ) in CIN . Methods From M ay 2013 to F ebruary 2014, 262 patients who underwent coronary angiography and/or percutaneous coronary intervention at S eoul N ational U niversity B oramae M edical C enter were enrolled. CIN was defined as either an increase in serum creatinine ≥ 22.1 μmol/L or ≥ 25% within 48 h after the procedure. Results Diabetes and chronic kidney disease accounted for 27.5% and 17.6% of the patients, respectively, and the mean age was 65 years. All patients received fluid therapy, and 36.3% underwent percutaneous coronary intervention. A total of 4.2% of the patients developed CIN ; younger age, underlying diseases (e.g., stroke and chronic kidney disease), the use of N ‐acetylcysteine, and elevated concentrations of ln( cTNFRs ) were associated with development of CIN . Increased values of ln( cTNFR1 ) ( OR 6.32, 95% CI 2.46–16.28, P < 0.001) and ln( cTNFR2 ) ( OR 3.24, 95% CI 1.26–8.31, P = 0.015) were significantly associated with CIN after adjusting for other risk factors, including baseline renal function. Moreover, an increase of cTNFRs levels was independently correlated with the deterioration of renal function. Conclusion Markedly elevated concentrations of circulating TNFRs were correlated with the occurrence of CIN and significantly associated with prolonged renal dysfunction regardless of the development of CIN .