Plasma Kidney Injury Molecule 1 in CKD: Findings From the Boston Kidney Biopsy Cohort and CRIC Studies.
Plasma Kidney Injury Molecule 1 in CKD: Findings From the Boston Kidney Biopsy Cohort and CRIC Studies.
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DOI：
10.1053/j.ajkd.2021.05.013
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Chronic Kidney Disease Biomarkers Consortium and the CRIC Study Investigators
中科院分区：
文献类型：
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作者：
Schmidt IM;Srivastava A;Sabbisetti V;McMahon GM;He J;Chen J;Kusek JW;Taliercio J;Ricardo AC;Hsu CY;Kimmel PL;Liu KD;Mifflin TE;Nelson RG;Vasan RS;Xie D;Zhang X;Palsson R;Stillman IE;Rennke HG;Feldman HI;Bonventre JV;Waikar SS;Chronic Kidney Disease Biomarkers Consortium and the CRIC Study Investigators
血浆肾损伤分子-1（KIM-1）是近端小管损伤的敏感标志物，但其与一系列肾脏疾病不良临床结局风险的相关性尚不清楚。前瞻性、观察性队列研究。524名受试者接受了具有临床指征的自体肾活检，活检标本由两名肾脏病理学家根据组织病理学半定量评分进行裁定，入组波士顿肾活检队列（BKBC）研究，3，800名患有常见形式慢性肾病（CKD）的受试者入组慢性肾功能不全队列（CRIC）研究。横断面分析中的组织学病变和临床病理诊断，前瞻性分析中的基线血浆KIM-1。横断面分析中的基线血浆KIM-1，前瞻性分析中的肾衰竭（定义为开始肾脏替代治疗）和死亡。多变量校正线性回归模型检测血浆KIM-1与组织病理学病变和临床病理学诊断的相关性。考克斯比例风险模型测试血浆KIM-1与未来肾衰竭和死亡的关联。在BKBC研究中，经多变量校正后，较高的血浆KIM水平与更严重的急性肾小管损伤、肾小管间质炎症和更严重的系膜扩张相关。糖尿病肾病、肾小球病和肾小管间质疾病的参与者在多变量调整后血浆KIM-1水平显著升高。在BKBC研究中，124名参与者进展为肾衰竭，85名参与者在中位随访时间5年内死亡。在CRIC研究中，1153名参与者进展为肾衰竭，1356名参与者在中位随访时间11.5年期间死亡。在两个队列中，血浆KIM-1的每次加倍均与多变量校正后肾衰竭风险增加相关（BKBC：HR 1.19，95% CI 1.03至1.38; CRIC：HR 1.10，95% CI 1.06至1.15）。在任一队列中，血浆KIM-1与死亡均无统计学显著相关性。普遍性和不可测量的混杂。血浆KIM-1与肾脏疾病个体的两项队列研究中潜在的肾小管间质和系膜病变以及进展为肾衰竭相关。肾小管损伤可能导致慢性肾脏病（CKD）的发展或进展。血浆KIM-1是肾小管损伤的敏感标志物，但其与肾脏疾病谱中不良临床结果的相关性尚不清楚。在两项针对常见和不同形式CKD患者的前瞻性队列研究中，较高的血浆KIM-1水平与肾衰竭进展独立相关。在接受自体肾活检的个体中，较高的血浆KIM-1水平与更严重的急性肾小管损伤、肾小管间质炎症和系膜扩张相关。总的来说，研究结果表明血浆KIM-1可以作为评估组织病理学病变的非侵入性工具，并对多种肾脏疾病具有预后价值。
Plasma kidney injury molecule-1 (KIM-1) is a sensitive marker of proximal tubule injury, but its association with risks of adverse clinical outcomes across a spectrum of kidney diseases is unknown. Prospective, observational cohort study. 524 individuals undergoing clinically indicated native kidney biopsy with biopsy specimens adjudicated for semiquantitative scores of histopathology by two kidney pathologists enrolled into the Boston Kidney Biopsy Cohort (BKBC) Study and 3,800 individuals with common forms of chronic kidney disease (CKD) enrolled into the Chronic Renal Insufficiency Cohort (CRIC) Study. Histopathologic lesions and clinicopathologic diagnosis in cross-sectional analyses, baseline plasma KIM-1 in prospective analyses. Baseline plasma KIM-1 in cross-sectional analyses, kidney failure (defined as initiation of kidney replacement therapy) and death in prospective analyses. Multivariable-adjusted linear regression models tested associations of plasma KIM-1 with histopathologic lesions and clinicopathologic diagnoses. Cox proportional hazards models tested associations of plasma KIM-1 with future kidney failure and death. In the BKBC Study, higher plasma KIM-levels were associated with more severe acute tubular injury, tubulointerstitial inflammation, and more severe mesangial expansion after multivariable adjustment. Participants with diabetic nephropathy, glomerulopathies, and tubulointerstitial disease had significantly higher plasma KIM-1 levels after multivariable adjustment. In the BKBC Study, 124 participants progressed to kidney failure and 85 participants died during a median follow-up time of 5 years. In the CRIC Study, 1153 participants progressed to kidney failure and 1356 participants died during a median follow-up time of 11.5 years. In both cohorts, each doubling of plasma KIM-1 was associated with an increased risk of kidney failure after multivariable adjustment (BKBC: HR 1.19, 95% CI 1.03 to 1.38 and CRIC: HR 1.10, 95% CI 1.06 to 1.15). There was no statistically significant association of plasma KIM-1 with death in either cohort. Generalizability and unmeasured confounding. Plasma KIM-1 is associated with underlying tubulointerstitial and mesangial lesions and progression to kidney failure in two cohort studies of individuals with kidney diseases. Kidney tubular injury may lead to the development or progression of chronic kidney disease (CKD). Plasma KIM-1 is a sensitive marker of tubular injury, but its association with adverse clinical outcomes across a spectrum of kidney diseases is not known. In two prospective cohort studies of individuals with common and diverse forms of CKD, higher plasma KIM-1 levels were independently associated with progression to kidney failure. In individuals who underwent a native kidney biopsy with adjudicated histopathology, higher plasma KIM-1 levels were associated with more severe acute tubular injury, tubulointerstitial inflammation, and mesangial expansion. Collectively, the findings suggest that plasma KIM-1 may serve as a non-invasive tool to assess histopathologic lesions and has prognostic value across a variety of kidney diseases.
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影响因子：
16.2
作者：
Nauta FL;Boertien WE;Bakker SJ;van Goor H;van Oeveren W;de Jong PE;Bilo H;Gansevoort RT
通讯作者：
Gansevoort RT
DOI：
10.1111/dom.13301
发表时间：
2018-08
期刊：
Diabetes, obesity & metabolism
影响因子：
--
作者：
Dekkers CCJ;Petrykiv S;Laverman GD;Cherney DZ;Gansevoort RT;Heerspink HJL
通讯作者：
Heerspink HJL
影响因子：
19.6
作者：
Nielsen, Stine E.;Andersen, Steen;Rossing, Peter
通讯作者：
Rossing, Peter
DOI：
10.1053/j.ajkd.2014.01.432
发表时间：
2014-07
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Driver TH;Katz R;Ix JH;Magnani JW;Peralta CA;Parikh CR;Fried L;Newman AB;Kritchevsky SB;Sarnak MJ;Shlipak MG;Health ABC Study
通讯作者：
Health ABC Study
影响因子：
19.6
作者：
通讯作者：
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