| Dokumentenart: | Artikel | ||||
|---|---|---|---|---|---|
| Titel eines Journals oder einer Zeitschrift: | Nephrology | ||||
| Verlag: | WILEY-BLACKWELL | ||||
| Ort der Veröffentlichung: | HOBOKEN | ||||
| Band: | 21 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 6 | ||||
| Seitenbereich: | S. 490-498 | ||||
| Datum: | 2016 | ||||
| Institutionen: | Medizin > Lehrstuhl für Innere Medizin II | ||||
| Identifikationsnummer: |
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| Stichwörter / Keywords: | WORSENING RENAL-FUNCTION; GELATINASE-ASSOCIATED LIPOCALIN; GLOMERULAR-FILTRATION-RATE; CARDIORENAL SYNDROME; URINARY BIOMARKERS; TUBULAR DAMAGE; IMPAIRMENT; METAANALYSIS; ASSOCIATION; DYSFUNCTION; cardiorenal syndrome; chronic kidney disease progression; tubular markers | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 42136 |
Web of ScienceZusammenfassung
Aim: Patients with chronic heart failure (CHF) are often characterized by the cardiorenal syndrome (CRS). The aim of the present study was to assess whether novel markers of kidney injury are able to predict progression of chronic kidney disease (CKD) in patients with CHF. Methods: New renal biomarkers, N-acteyl-beta-D-glucosaminidase (NAG), kidney injury molecule-1 (KIM-1) and Neutrophil ...
Zusammenfassung
Aim: Patients with chronic heart failure (CHF) are often characterized by the cardiorenal syndrome (CRS). The aim of the present study was to assess whether novel markers of kidney injury are able to predict progression of chronic kidney disease (CKD) in patients with CHF. Methods: New renal biomarkers, N-acteyl-beta-D-glucosaminidase (NAG), kidney injury molecule-1 (KIM-1) and Neutrophil Gelatinase-Associated Lipocalin (NGAL), were assessed from urine samples of 149 patients with chronic heart failure. During a 5-year-follow-up, renal function was assessed by creatinine and estimated glomerular filtration rate (eGFR CKD EPI) and was available for 138 patients. Further, data regarding all-cause mortality was obtained. Results: Twenty-six patients (18.8%) developed a progression of CKD during the follow-up period, as defined by decline in eGFR category accompanied by a =25% drop in eGFR form baseline. No difference regarding age, sex, body mass index, hypertension, diabetes or EF was present between patients with andwithout CKD progression (each P=n. s.). At baseline, creatinine concentrations and eGFR were significantly different between both groups (sCr: 1.50 +/- 0.67 vs 1.04 +/- 0.37, P=<0.001; eGFR: 47.8 +/- 12.3 vs. 77.3 +/- 23.5 mL/min per 1.73m2, each P<0.001). In a Kaplan-Meier-analysis, KIM-1 and NAG were significant predictors for CKD progression (both P<0.05). In Cox regression analysis, NAG > median (OR 3.25, P =0.013), initial eGFR (OR 0.94, P<0.001) and diuretic use (OR 3.92, P=0.001) were independent predictors of CKD progression. Further, KIM-1 andNAGwere also independent predictors of a combined endpoint of CKD progression and all-cause mortality by Cox regression analysis (each P<0.05). The combination of both markers showed additive value regarding both endpoints. NGAL showed no association with CKD progression. Conclusions: During long-term follow-up chronic heart failure patients with CKD show a relevant disease progression. The current study emphasizes a strong association of the tubular biomarkers NAG and KIM-1 with CKD progression in chronic heart failure and suggests their usefulness as cardiorenal markers.
Metadaten zuletzt geändert: 17 Mrz 2020 11:25
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