End-Stage Renal Disease After Renal Surgery in Patients with Normal Preoperative Kidney Function: Balancing Surgical Strategy and Individual Disorders at Baseline

Introduction: Carotid intima-media thickness (IMT) has been reported to predict kidney function decline. However, whether carotid IMT is associated with a hard kidney endpoint, end-stage renal disease (ESRD), has not been investigated. Hypothesis: We assessed the hypothesis that increased carotid IMT is associated with ESRD risk. Methods: We studied 13,197 ARIC participants at visit 1 (1987-1989) without history of cardiovascular disease including coronary heart disease, stroke and heart failure and assessed whether carotid IMT measured by B-mode ultrasound is associated with ESRD risk using Cox proportional-hazards models. Regarding carotid IMT parameters, we investigated the mean and maximum values of overall and segment-specific (common, bifurcation and internal carotid arteries) measurements. Results: Mean age was 54.0 (SD 5.7) years, and there were 3,373 (25.6%) blacks and 7,370 (55.8%) women. During a median follow-up of 22.7 years, 433 participants developed ESRD (1.4/1,000 person-years). After adjusting for shared risk factors for atherosclerosis and kidney disease, including baseline kidney function, carotid IMT was significantly associated with ESRD risk (hazard ratios between quartiles 4 and 1, 1.43 [95%CI: 1.01-2.04] for overall mean IMT and 1.73 [95%CI: 1.22-2.44] for overall maximum IMT). The associations were largely consistent in demographic and clinical subgroups. When we explored segment-specific IMTs, the associations with ESRD were most robust for bifurcation carotid. The adjusted hazard ratios between quartiles 4 and 1 were 1.48 (95%CI: 1.04-2.11) for mean bifurcation IMT and 1.42 (95%CI: 0.99-2.03) for maximum bifurcation IMT. Conclusions: Carotid IMT was independently associated with incident ESRD in the general population. Our findings suggest the shared etiology between atherosclerosis and ESRD and highlight the importance of monitoring kidney function over time in individuals with subclinical atherosclerosis.

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Urinary uromodulin independently predicts end-stage renal disease and rapid kidney function decline in a cohort of chronic kidney disease patients

Medicine ◽

10.1097/md.0000000000015808 ◽

2019 ◽

Vol 98 (21) ◽

pp. e15808 ◽

Cited By ~ 2

Author(s):

Dominik Steubl ◽

Matthias Block ◽

Victor Herbst ◽

Wolfgang Andreas Nockher ◽

Wolfgang Schlumberger ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Renal Disease ◽

Kidney Function ◽

End Stage Renal Disease ◽

Stage Renal Disease ◽

End Stage ◽

Kidney Function Decline

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Serum Beta-Trace Protein versus Glomerulus Filtration Rate as a Predictor for Kidney Function among Hypertensive Patients

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v27i2.1618 ◽

2021 ◽

Vol 27 (2) ◽

pp. 127

Author(s):

Ranisa Handayani ◽

Yuyun Widaningsih ◽

Fitriani Mangarengi ◽

Uleng Bahrun

Keyword(s):

Logistic Regression ◽

Renal Disease ◽

Kidney Function ◽

End Stage Renal Disease ◽

Filtration Rate ◽

Hypertensive Patients ◽

Regression Test ◽

Stage Renal Disease ◽

End Stage ◽

Logistic Regression Test

Beta-Trace Protein (BTP) is a low-molecular-weight glycoprotein that can convert prostaglandin H2 into prostaglandin D2 and is associated with the vascular function's alteration. Serum beta-trace protein has been proposed as a promising marker in predicting kidney function in hypertensive patients. This study aimed to analyze the correlation between BTP and glomerulus filtration rate, particularly in hypertensive patients. A cross-sectional survey was conducted on 70 hypertensive participants admitted to Dr. Wahidin Sudirohusodo Hospital from July-August 2019. Beta-trace protein, serum urea, creatinine, blood pressure, and anthropometric were measured. The Glomerulus Filtration Rate (GFR) with Cockcroft Gault was graded using GFR stages. The hypertension was graded according to the category of the European Society of Cardiology (ESC) 2018. A descriptive test, Kruskal-Wallis test, Fisher exact test, Spearman correlation test, and logistic regression test were performed at a confidence level of 95%. Significant differences were found between the age, systole, diastole, blood urea, creatinine, and GFR (p=< 0.05). There was a significant difference between GFR and the degree of hypertension (p=< 0.001), but no differences were found in the mean value of BTP and the degree of hypertension (p=0.348). A significant negative correlation was found between GFR and BTP (p=0.028, r = -0.263). Logistic regression test s showed that the increased BTP led to 2.591 times greater possibility of end-stage renal disease with GFR < 15 mL/min/ 2 1.73 m (crude odds ratio 95% CI 1.168-5.475). Serum beta-trace protein possesses a prognostic ability of glomerulus filtration rate and can be used to predict the odd of end-stage renal disease in hypertensive patients.

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