Soluble urokinase plasminogen activator receptor and decline in kidney function among patients without kidney disease
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Soluble urokinase plasminogen activator receptor and decline in kidney function among patients without kidney disease. / Iversen, Esben; Kallemose, Thomas; Hornum, Mads; Bengaard, Anne Kathrine; Nehlin, Jan Olof; Rasmussen, Line Jee Hartmann; Sandholdt, Haakon; Tavenier, Juliette; Feldt-Rasmussen, Bo; Andersen, Ove; Eugen-Olsen, Jesper; Houlind, Morten Baltzer.
In: Clinical Kidney Journal, Vol. 15, No. 8, 2022, p. 1534-1541.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Soluble urokinase plasminogen activator receptor and decline in kidney function among patients without kidney disease
AU - Iversen, Esben
AU - Kallemose, Thomas
AU - Hornum, Mads
AU - Bengaard, Anne Kathrine
AU - Nehlin, Jan Olof
AU - Rasmussen, Line Jee Hartmann
AU - Sandholdt, Haakon
AU - Tavenier, Juliette
AU - Feldt-Rasmussen, Bo
AU - Andersen, Ove
AU - Eugen-Olsen, Jesper
AU - Houlind, Morten Baltzer
N1 - Publisher Copyright: © 2022 The Author(s). Published by Oxford University Press on behalf of the ERA.
PY - 2022
Y1 - 2022
N2 - Background: Hospitalized patients are at an increased risk of developing kidney disease after discharge, often despite the absence of any clinical indicators during hospitalization. Soluble urokinase plasminogen activator receptor (suPAR) is a marker of systemic chronic inflammation that can be measured from routine blood samples. We determined whether elevated suPAR during hospitalization is associated with a decline in estimated glomerular filtration rate (eGFR) after discharge. Methods: This was a retrospective longitudinal cohort study of patients without detectable kidney disease presenting to the emergency department on two separate occasions during a 3-year period. The association between suPAR and a decline in eGFR was assessed by linear mixed models for repeated measures adjusting for age, sex, C-reactive protein, sodium, diabetes, hypertension and cardiovascular disease. Results: In total, 5124 patients (median age 65.9 years, 51.0% female) were included. The median suPAR was 2.9 ng/mL, the median time to readmission was 144 days and the expected rate of eGFR decline over this period was 5.1 mL/min/1.73 m2/year. Adjusting for other risk factors, patients with suPAR <3, 3-6 or ≥6 ng/mL had an expected eGFR decline of 4.3, 5.2 or 9.0 mL/min/1.73 m2/year, respectively. Similarly, patients with suPAR in the lowest (<2.4 ng/mL), middle (2.4-3.6 ng/mL) or highest (≥3.6 ng/mL) tertile had an expected eGFR decline of 4.2, 4.6 or 6.5 mL/min/1.73 m2/year, respectively. In both cases, a higher suPAR level was significantly and independently associated with a higher rate of eGFR decline (P <. 001). Conclusions: A higher suPAR level was associated with accelerated eGFR decline among patients presenting to the emergency department, suggesting that routine suPAR measurements may have utility for the early detection of kidney disease.
AB - Background: Hospitalized patients are at an increased risk of developing kidney disease after discharge, often despite the absence of any clinical indicators during hospitalization. Soluble urokinase plasminogen activator receptor (suPAR) is a marker of systemic chronic inflammation that can be measured from routine blood samples. We determined whether elevated suPAR during hospitalization is associated with a decline in estimated glomerular filtration rate (eGFR) after discharge. Methods: This was a retrospective longitudinal cohort study of patients without detectable kidney disease presenting to the emergency department on two separate occasions during a 3-year period. The association between suPAR and a decline in eGFR was assessed by linear mixed models for repeated measures adjusting for age, sex, C-reactive protein, sodium, diabetes, hypertension and cardiovascular disease. Results: In total, 5124 patients (median age 65.9 years, 51.0% female) were included. The median suPAR was 2.9 ng/mL, the median time to readmission was 144 days and the expected rate of eGFR decline over this period was 5.1 mL/min/1.73 m2/year. Adjusting for other risk factors, patients with suPAR <3, 3-6 or ≥6 ng/mL had an expected eGFR decline of 4.3, 5.2 or 9.0 mL/min/1.73 m2/year, respectively. Similarly, patients with suPAR in the lowest (<2.4 ng/mL), middle (2.4-3.6 ng/mL) or highest (≥3.6 ng/mL) tertile had an expected eGFR decline of 4.2, 4.6 or 6.5 mL/min/1.73 m2/year, respectively. In both cases, a higher suPAR level was significantly and independently associated with a higher rate of eGFR decline (P <. 001). Conclusions: A higher suPAR level was associated with accelerated eGFR decline among patients presenting to the emergency department, suggesting that routine suPAR measurements may have utility for the early detection of kidney disease.
KW - acute
KW - emergency department
KW - estimated glomerular filtration rate
KW - kidney disease
KW - soluble urokinase plasminogen activator receptor
U2 - 10.1093/ckj/sfac048
DO - 10.1093/ckj/sfac048
M3 - Journal article
C2 - 35892012
AN - SCOPUS:85142609373
VL - 15
SP - 1534
EP - 1541
JO - Clinical Kidney Journal
JF - Clinical Kidney Journal
SN - 2048-8505
IS - 8
ER -
ID: 330836304