Associations of Urine Epidermal Growth Factor With Kidney and Cardiovascular Outcomes in Individuals With CKD in SPRINT
Introduction: Urine epidermal growth factor (uEGF) has been found to be inversely associated with kidney function loss, whereas its associations with cardiovascular disease (CVD) and mortality have not been studied. Methods: We measured baseline uEGF levels among 2346 Systolic Blood Pressure Interve...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-11-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S246802492401876X |
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| author | Merve Postalcioglu Ronit Katz Simon B. Ascher Trenton Hall Pranav S. Garimella Stein I. Hallan Joachim H. Ix Michael G. Shlipak |
| author_facet | Merve Postalcioglu Ronit Katz Simon B. Ascher Trenton Hall Pranav S. Garimella Stein I. Hallan Joachim H. Ix Michael G. Shlipak |
| author_sort | Merve Postalcioglu |
| collection | DOAJ |
| description | Introduction: Urine epidermal growth factor (uEGF) has been found to be inversely associated with kidney function loss, whereas its associations with cardiovascular disease (CVD) and mortality have not been studied. Methods: We measured baseline uEGF levels among 2346 Systolic Blood Pressure Intervention Trial (SPRINT) participants with an estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m2. A linear mixed-effects model was used to investigate the associations of uEGF with the annual eGFR change; Cox proportional hazards regression models were used to analyze its associations with the ≥30% eGFR decline, CVD, and all-cause mortality outcomes. To account for the competing risk of death, the Fine and Gray method was utilized for acute kidney injury (AKI) and end-stage kidney disease (ESKD) outcomes. Results: At baseline, the study participants had mean age of 73 ± 9 years, mean eGFR of 46 ± 11 ml/min per 1.73 m2, and median urine albumin-to-creatinine ratio (UACR) of 15 mg/g (interquartile range: 7–49). In the multivariable-adjusted analysis including baseline urine albumin and eGFR, each 50% lower uEGF concentration was associated with 0.74% (95% confidence interval [CI]: 0.29–1.19) per year faster decline in eGFR and 1.17 times higher risk of ≥30% eGFR decline (95% CI: 1.00–1.36). Lower uEGF concentrations were found to be associated with increased risks of ESKD, AKI, CVD, and all-cause mortality; however, these associations did not reach statistical significance when the models were controlled for baseline urine albumin and eGFR. Conclusion: Among hypertensive adults with chronic kidney disease (CKD), lower baseline uEGF concentration was associated with faster eGFR decline independent of baseline albuminuria and eGFR; but not with ESKD, AKI, CVD, and all-cause mortality. |
| format | Article |
| id | doaj-art-18ae7447d6d84b2c88ee8a53750eeafc |
| institution | Kabale University |
| issn | 2468-0249 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-18ae7447d6d84b2c88ee8a53750eeafc2025-08-20T03:45:06ZengElsevierKidney International Reports2468-02492024-11-019113167317610.1016/j.ekir.2024.08.004Associations of Urine Epidermal Growth Factor With Kidney and Cardiovascular Outcomes in Individuals With CKD in SPRINTMerve Postalcioglu0Ronit Katz1Simon B. Ascher2Trenton Hall3Pranav S. Garimella4Stein I. Hallan5Joachim H. Ix6Michael G. Shlipak7Kidney Health Research Collaborative, Veterans Affairs San Francisco Healthcare System and University of California San Francisco, San Francisco, California, USADepartment of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USAKidney Health Research Collaborative, Veterans Affairs San Francisco Healthcare System and University of California San Francisco, San Francisco, California, USA; Division of Hospital Medicine, Department of Medicine, University of California Davis, Sacramento, California, USAKidney Health Research Collaborative, Veterans Affairs San Francisco Healthcare System and University of California San Francisco, San Francisco, California, USADivision of Nephrology and Hypertension, Department of Medicine, University of California San Diego, San Diego, California, USADepartment of Nephrology, St Olav's Hospital and Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, NorwayDivision of Nephrology and Hypertension, Department of Medicine, University of California San Diego, San Diego, California, USA; Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California, USAKidney Health Research Collaborative, Veterans Affairs San Francisco Healthcare System and University of California San Francisco, San Francisco, California, USA; Correspondence: Michael Shlipak, University of California, 4150 Clement Street, Building 2, Room 455C, San Francisco, California, 94121, USA.Introduction: Urine epidermal growth factor (uEGF) has been found to be inversely associated with kidney function loss, whereas its associations with cardiovascular disease (CVD) and mortality have not been studied. Methods: We measured baseline uEGF levels among 2346 Systolic Blood Pressure Intervention Trial (SPRINT) participants with an estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m2. A linear mixed-effects model was used to investigate the associations of uEGF with the annual eGFR change; Cox proportional hazards regression models were used to analyze its associations with the ≥30% eGFR decline, CVD, and all-cause mortality outcomes. To account for the competing risk of death, the Fine and Gray method was utilized for acute kidney injury (AKI) and end-stage kidney disease (ESKD) outcomes. Results: At baseline, the study participants had mean age of 73 ± 9 years, mean eGFR of 46 ± 11 ml/min per 1.73 m2, and median urine albumin-to-creatinine ratio (UACR) of 15 mg/g (interquartile range: 7–49). In the multivariable-adjusted analysis including baseline urine albumin and eGFR, each 50% lower uEGF concentration was associated with 0.74% (95% confidence interval [CI]: 0.29–1.19) per year faster decline in eGFR and 1.17 times higher risk of ≥30% eGFR decline (95% CI: 1.00–1.36). Lower uEGF concentrations were found to be associated with increased risks of ESKD, AKI, CVD, and all-cause mortality; however, these associations did not reach statistical significance when the models were controlled for baseline urine albumin and eGFR. Conclusion: Among hypertensive adults with chronic kidney disease (CKD), lower baseline uEGF concentration was associated with faster eGFR decline independent of baseline albuminuria and eGFR; but not with ESKD, AKI, CVD, and all-cause mortality.http://www.sciencedirect.com/science/article/pii/S246802492401876Xcardiovascular diseasechronic kidney diseaseepidermal growth factorkidney tubule biomarkermortalitySPRINT |
| spellingShingle | Merve Postalcioglu Ronit Katz Simon B. Ascher Trenton Hall Pranav S. Garimella Stein I. Hallan Joachim H. Ix Michael G. Shlipak Associations of Urine Epidermal Growth Factor With Kidney and Cardiovascular Outcomes in Individuals With CKD in SPRINT Kidney International Reports cardiovascular disease chronic kidney disease epidermal growth factor kidney tubule biomarker mortality SPRINT |
| title | Associations of Urine Epidermal Growth Factor With Kidney and Cardiovascular Outcomes in Individuals With CKD in SPRINT |
| title_full | Associations of Urine Epidermal Growth Factor With Kidney and Cardiovascular Outcomes in Individuals With CKD in SPRINT |
| title_fullStr | Associations of Urine Epidermal Growth Factor With Kidney and Cardiovascular Outcomes in Individuals With CKD in SPRINT |
| title_full_unstemmed | Associations of Urine Epidermal Growth Factor With Kidney and Cardiovascular Outcomes in Individuals With CKD in SPRINT |
| title_short | Associations of Urine Epidermal Growth Factor With Kidney and Cardiovascular Outcomes in Individuals With CKD in SPRINT |
| title_sort | associations of urine epidermal growth factor with kidney and cardiovascular outcomes in individuals with ckd in sprint |
| topic | cardiovascular disease chronic kidney disease epidermal growth factor kidney tubule biomarker mortality SPRINT |
| url | http://www.sciencedirect.com/science/article/pii/S246802492401876X |
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