The Associations of Plasma Biomarkers of Inflammation With Histopathologic Lesions, Kidney Disease Progression, and Mortality-The Boston Kidney Biopsy Cohort Study

© 2021 International Society of Nephrology. Published by Elsevier Inc..

BACKGROUND: Soluble tumor necrosis factor receptor (sTNFR)-1, sTNFR-2, YKL-40, monocyte chemoattractant protein (MCP)-1, and soluble urokinase plasminogen activator receptor (suPAR) have emerged as promising biomarkers of inflammation but have not been evaluated across diverse types of kidney diseases.

METHODS: We measured these plasma biomarkers in 523 individuals enrolled into a prospective, observational cohort study of patients undergoing clinically indicated native kidney biopsy at 3 tertiary care hospitals. Two kidney pathologists adjudicated biopsy specimens for semiquantitative scores of histopathology. Proportional hazard models tested associations between biomarkers and risks of kidney disease progression (composite of ≥40% estimated glomerular filtration rate [eGFR] decline or end-stage kidney disease [ESKD]) and death.

RESULTS: Mean eGFR was 56.4±36 ml/min per 1.73 m2 and the median proteinuria (interquartile range) was 1.6 (0.4, 3.9) g/g creatinine. The most common primary clinicopathologic diagnoses were proliferative glomerulonephritis (29.2%), nonproliferative glomerulopathy (18.1%), advanced glomerulosclerosis (11.3%), and diabetic kidney disease (11.1%). sTNFR-1, sTNFR-2, MCP-1, and suPAR were associated with tubulointerstitial and glomerular lesions. YKL-40 was not associated with any histopathologic lesions after multivariable adjustment. During a median follow-up of 65 months, 182 participants suffered kidney disease progression and 85 participants died. After multivariable adjustment, each doubling of sTNFR-1, sTNFR-2, YKL-40, and MCP-1 was associated with increased risks of kidney disease progression, with hazard ratios ranging from 1.21 to 1.47. Each doubling of sTNFR-2, YKL-40, and MCP-1 was associated with increased risks of death, with hazard ratios ranging from 1.33 to 1.45. suPAR was not significantly associated with kidney disease progression or death.

CONCLUSIONS: sTNFR-1, sTNFR-2, YKL-40, MCP-1, and suPAR are associated with underlying histopathologic lesions and adverse clinical outcomes across a diverse set of kidney diseases.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:6

Enthalten in:

Kidney international reports - 6(2021), 3 vom: 20. März, Seite 685-694

Sprache:

Englisch

Beteiligte Personen:

Srivastava, Anand [VerfasserIn]
Schmidt, Insa M [VerfasserIn]
Palsson, Ragnar [VerfasserIn]
Weins, Astrid [VerfasserIn]
Bonventre, Joseph V [VerfasserIn]
Sabbisetti, Venkata [VerfasserIn]
Stillman, Isaac E [VerfasserIn]
Rennke, Helmut G [VerfasserIn]
Waikar, Sushrut S [VerfasserIn]

Links:

Volltext

Themen:

Biomarker
Fibrosis
Histopathology
Inflammation
Journal Article
Kidney biopsy
Kidney disease

Anmerkungen:

Date Revised 21.04.2022

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.1016/j.ekir.2020.12.025

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM322895634