Associations of urinary levels of kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) with kidney function decline in the Multi-Ethnic Study of Atherosclerosis (MESA).
Associations of urinary levels of kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) with kidney function decline in the Multi-Ethnic Study of Atherosclerosis (MESA).
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DOI：
10.1053/j.ajkd.2012.05.014
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发表时间：
2012-12
期刊：
影响因子：
--
通讯作者：
Shlipak MG
中科院分区：
文献类型：
--
作者：
Peralta CA;Katz R;Bonventre JV;Sabbisetti V;Siscovick D;Sarnak M;Shlipak MG
肾小管损伤的尿生物标志物（尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和肾损伤分子1（KIM-1））的升高是否与未来肾脏疾病的风险相关尚未研究。1：1巢式病例对照研究，686名参与者参与了多种族动脉粥样硬化研究（梅萨）。NGAL和KIM-1在基线时测量，并表示为对数转换的连续变量，并分类为十分位数。使用CKD-EPI（慢性肾脏病流行病学协作组）方程通过半胱氨酸蛋白酶抑制剂C评估肾功能。CKD 3期事件定义为eGFR <60 ml/min/1.73m2且eGFR每年下降>1 ml/min/1.73m2，快速肾功能下降（RKFD）定义为每年下降≥3 ml/min/1.73m2。病例定义为eGFR >60 ml/min/1.73 m2，随后发生CKD 3期事件和/或梅萨第5年访视时发生RKFD的患者。对照组的年龄、性别、种族、糖尿病和基线eGFR相匹配。我们调整了年龄、高血压和蛋白尿（ACR ≥30 mg/g）。在343例病例中，145例发生了CKD 3期，141例发生了RKFD，57例同时发生。对照组的平均eGFR基线为81（±10）ml/min/1.73 m2，随访时为80（±10）ml/min/1.73 m2，而病例组为82（±13）ml/min/1.73 m2和58（± 10）ml/min/1.73 m2。KIM-1（pg/ml）每增加一倍，发生CKD 3期和/或RKFD的OR为1.15（95% CI，1.02-1.29）。与最低的90%相比，KIM-1的最高十分位数与结果的OR为2.02（95%CI，1.15-3.56）相关;这些相关性与白蛋白尿无关。NGAL水平（ng/ml）与CKD 3期和/或RKFD事件无关（OR，1.04; 95% CI，0.99-1.10）。当KIM-1和NGAL以尿肌酐标准化时，结果相似。病例对照设计限制了对死亡或无法进行随访的患者进行解释的能力。尿KIM-1与独立于白蛋白尿的未来肾脏疾病风险相关。肾小管损伤的尿液生物标志物是识别CKD风险人群的一种有前途的工具。
Whether elevations of urinary biomarkers of tubular injury (urine neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule 1 (KIM-1)) are associated with future risk of kidney disease has not been investigated. 1:1 nested case-control study 686 participants in the Multi-Ethnic Study of Atherosclerosis (MESA). NGAL and KIM-1 were measured at baseline and expressed as log-transformed continuous variables and categorized into deciles. Kidney function was estimated by cystatin C using the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation. Incident CKD Stage 3 was defined as eGFR <60 ml/min/1.73m2 and a eGFR decline >1 ml/min/1.73m2 per year, and rapid kidney function decline (RKFD) was defined as decline of ≥3 ml/min/1.73m2 per year. Cases were defined as persons with eGFR >60 ml/min/1.73m2 who subsequently developed incident CKD Stage 3 and/or had RKFD by MESA year 5 visit. Controls were matched for age, gender, race, diabetes, and baseline eGFR. We adjusted for age, hypertension and presence of albuminuria (ACR ≥30 mg/g). Of the 343 cases, 145 had incident CKD Stage 3, 141 had RKFD and 57 had both. Mean eGFR for controls was 81 (±10) ml/min/1.73m2 at baseline and 80 (±10) at follow-up, compared with 82 (±13) and 58 (±10) for cases. Each doubling of KIM-1 (pg/ml) was associated with an OR of 1.15 (95% CI, 1.02-1.29) for incident CKD Stage 3 and/or RKFD. Compared to the lowest 90%, the highest decile of KIM-1 was associated with an OR of 2.02 (95% CI, 1.15-3.56) for the outcome; these associations were independent of albuminuria. NGAL levels (ng/ml) were not associated with incident CKD Stage 3 and/or RKFD (OR, 1.04; 95% CI, 0.99-1.10). Results were similar when KIM-1 and NGAL were standardized for urine creatinine. The case-control design limits ability to account for persons who died or were not available for follow-up. Urinary KIM-1 is associated with future risk of kidney disease independent of albuminuria. Urinary biomarkers of tubular injury are a promising tool for identifying persons at risk for CKD.
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影响因子：
39.2
作者：
Nickolas, Thomas L.;O'Rourke, Matthew J.;Barasch, Jonathan
通讯作者：
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影响因子：
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作者：
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DOI：
10.2215/cjn.04810908
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作者：
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影响因子：
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作者：
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