The Associations of Plasma Biomarkers of Inflammation With Histopathologic Lesions, Kidney Disease Progression, and Mortality-The Boston Kidney Biopsy Cohort Study.
The Associations of Plasma Biomarkers of Inflammation With Histopathologic Lesions, Kidney Disease Progression, and Mortality-The Boston Kidney Biopsy Cohort Study.
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炎症血浆生物标志物与组织病理学损伤、肾脏疾病进展和死亡率的关联——波士顿肾活检队列研究
DOI：
10.1016/j.ekir.2020.12.025
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发表时间：
2021-03
影响因子：
6
通讯作者：
Waikar SS
中科院分区：
文献类型：
--
作者：
Srivastava A;Schmidt IM;Palsson R;Weins A;Bonventre JV;Sabbisetti V;Stillman IE;Rennke HG;Waikar SS
可溶性肿瘤坏死因子受体（sTNFR）-1、sTNFR - 2、人软骨糖蛋白39（YKL - 40）、单核细胞趋化蛋白（MCP）-1和可溶性尿激酶型纤溶酶原激活物受体（suPAR）已成为有前景的炎症生物标志物，但尚未在多种肾脏疾病中进行评估。
我们对523名个体的这些血浆生物标志物进行了检测，这些个体参与了一项前瞻性观察队列研究，研究对象是在3家三级医院因临床需要接受 native kidney biopsy（肾穿刺活检）的患者。两名肾脏病理学家对活检标本进行判定，给出组织病理学的半定量评分。比例风险模型检验了生物标志物与肾脏疾病进展风险（估计肾小球滤过率[eGFR]下降≥40%或终末期肾病[ESKD]的复合情况）以及死亡之间的关联。
平均eGFR为52.4±36 ml/min/1.73 m²，蛋白尿中位数（四分位间距）为1.6（0.4，3.9）g/g肌酐。最常见的原发性临床病理诊断为增殖性肾小球肾炎（29.2%）、非增殖性肾小球病（18.1%）、晚期肾小球硬化（11.3%）和糖尿病肾病（11.1%）。sTNFR - 1、sTNFR - 2、MCP - 1和suPAR与肾小管间质和肾小球病变相关。在多变量调整后，YKL - 40与任何组织病理学病变均无关。在中位随访65个月期间，182名参与者出现肾脏疾病进展，85名参与者死亡。经过多变量调整后，sTNFR - 1、sTNFR - 2、YKL - 40和MCP - 1每翻倍一次，肾脏疾病进展的风险就会增加，风险比范围从1.21到1.47。sTNFR - 2、YKL - 40和MCP - 1每翻倍一次，死亡风险就会增加，风险比范围从1.33到1.45。suPAR与肾脏疾病进展或死亡无显著关联。
sTNFR - 1、sTNFR - 2、YKL - 40、MCP - 1和suPAR与多种肾脏疾病的潜在组织病理学病变和不良临床结局相关。
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. 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. 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. 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.
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影响因子：
158.5
作者：
Hayek, Salim S.;Leaf, David E.;Reiser, Jochen
通讯作者：
Reiser, Jochen
影响因子：
8.2
作者：
Heerspink, Hiddo J. L.;Perco, Paul;Mayer, Gert
通讯作者：
Mayer, Gert
DOI：
10.2215/cjn.12051115
发表时间：
2016-08-01
影响因子：
9.8
作者：
Nadkarni, Girish N.;Rao, Veena;Coca, Steven G.
通讯作者：
Coca, Steven G.
影响因子：
13.6
作者：
Montgomery, Tinika A.;Xu, Leyuan;Cantley, Lloyd G.
通讯作者：
Cantley, Lloyd G.
DOI：
10.1152/ajprenal.00421.2009
发表时间：
2010-03-01
影响因子：
4.2
作者：
Kim, Hyun Ju;Vaziri, Nosratola D.
通讯作者：
Vaziri, Nosratola D.