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Circulating TNF receptors predict cardiovascular disease in patients with chronic kidney disease

Authors
 Eunjin Bae  ;  Ran-Hui Cha  ;  Yong C. Kim  ;  Jung N. An  ;  Dong K. Kim  ;  Kyung D. Yoo  ;  Su M. Lee  ;  Myoung-Hee Kim  ;  Jung T. Park  ;  Shin-Wook Kang  ;  Jae Y. Park  ;  Chun S. Lim  ;  Yon S. Kim  ;  Seung H. Yang  ;  Jung P. Lee 
Citation
 MEDICINE, Vol.96(19) : 6666, 2017 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2017
MeSH
Adult ; Aged ; Blood Chemical Analysis ; Cardiovascular Diseases/blood* ; Cardiovascular Diseases/complications* ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/urine ; Creatinine/urine ; Eccrine Porocarcinoma ; Enzyme-Linked Immunosorbent Assay ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Prospective Studies ; Receptors, Tumor Necrosis Factor, Type I/blood* ; Receptors, Tumor Necrosis Factor, Type II/blood* ; Renal Insufficiency, Chronic/blood* ; Renal Insufficiency, Chronic/complications* ; Renal Insufficiency, Chronic/mortality ; Renal Insufficiency, Chronic/urine ; Risk Factors
Keywords
cardiovascular disease ; chronic kidney disease ; circulating TNF receptor 1 ; circulating TNF receptor 2
Abstract
Cardiovascular disease (CVD) is the main public health problem in patients with chronic kidney disease (CKD); however, there is no established biomarker for predicting CVD morbidity and mortality in CKD. The aim of this study was to evaluate the role of circulating tumor necrosis factor receptors (cTNFRs) in predicting CVD risk in CKD patients.We prospectively recruited 984 patients with CKD from 11 centers between 2006 and 2012. The levels of cTNFR1 and cTNFR2 were determined by performing an enzyme-linked immunosorbent assay. During the mean follow-up period of 4 years, 36 patients experienced a CVD event. The median serum concentrations of cTNFR1 and cTNFR2 were 2703.4 (225.6-13,057.7) and 5661.0 (634.9-30,599.6) pg/mL, respectively, and the cTNFR1 level was closely correlated with the cTNFR2 level (r = 0.86, P < .0001). The urinary protein-to-creatinine ratio (UPCR) and estimated glomerular filtration rate (eGFR) were significantly correlated with the cTNFR2 level (r = 0.21 for UPCR, r = -0.67 for eGFR; P < .001 for all). Similar correlations were observed for serum cTNFR1 (r = 0.21 for UPCR, r = -0.75 for eGFR; P < .001 for all). In the Cox proportional hazard analyses, cTNFR1 (hazard ratio [HR] 2.506, 95% confidence interval [CI] 1.186-5.295, P = .016) and cTNFR2 (HR 4.156, 95% CI 1.913-9.030, P < .001) predicted CVD risk even after adjustment for clinical covariates, such as UPCR, eGFR, and high-sensitivity C-reactive protein. cTNFR1 and 2 are associated with CVD and other risk factors in CKD, independently of eGFR and UPCR. Furthermore, cTNFRs could be relevant predictors of CVD in CKD patients.
Files in This Item:
T201701822.pdf Download
DOI
10.1097/MD.0000000000006666
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154303
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