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Soluble TWEAK and PTX3 in nondialysis CKD patients: Impact on endothelial dysfunction and cardiovascular outcomes
Entity
UAM. Departamento de MedicinaPublisher
American Society of NephrologyDate
2011-04-01Citation
10.2215/CJN.09231010
Clinical Journal of the American Society of Nephrology 6 (2011): 785-792
ISSN
1555-9041 (print); 1555-905X (online)DOI
10.2215/CJN.09231010Funded by
we acknowledge support from Gülhane School of Medicine, Karolinska Institutet’s Diabetes Theme Center, the Loo and Hans Osterman Foundation, Fondo de Investigaciones Sanitarias (Programa Miguel Servet to LB-C), and Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo (RETICS RD06/0014/0035; PI10/00234Project
Gobierno de España. RD06/0014/0035Editor's Version
http://dx.doi.org/10.2215/CJN.09231010Subjects
PTX3; sTWEAK levels; Endothelial dysfunction; Cardiovascular Outcomes; MedicinaRights
© 2011 by the American Society of NephrologyAbstract
Background and objectives Chronic kidney disease (CKD) conveys high mortality rates. Soluble TNF-like
weak inducer of apoptosis (sTWEAK) and long pentraxin 3 (PTX3) are predictors of mortality in dialysis
patients and determinants of endothelial dysfunction. Now, we hypothesize that both sTWEAK and PTX3
act as biomarkers of cardiovascular outcomes in nondialysis CKD patients.
Design, setting, participants, & measurements Cross-sectional analysis in which flow-mediated dilation
(FMD) and intima-media thickness (IMT) were assessed in 257 nondialysis stage 1 to 5 CKD patients (mean
age, 52 12 years; 130 men), together with biochemical measurements and sTWEAK and PTX3 assessments.
Patients were followed for cardiovascular outcomes.
Results PTX3 and IMT increased, whereas FMD and sTWEAK decreased across CKD stages (P 0.001 for
all). Both PTX3 and sTWEAK appeared as strong determinants of FMD in multivariate analysis. The univariate
associations of sTWEAK and PTX3 with IMT were dependent on estimated GFR. After a median of
39 months (range, 2 to 43 months), 22 fatal and 57 nonfatal cardiovascular events occurred. In a Cox model
excluding PTX3, decreasing sTWEAK concentration was associated with increased risk of cardiovascular
events independently of basic confounders (age, gender, estimated GFR, C reactive protein, diabetes, and
cardiovascular comorbidity) and FMD. In a model excluding sTWEAK, circulating levels of PTX3 were directly
associated with cardiovascular outcomes independently of basic confounders, but this association
was lost after adjustment for FMD.
Conclusions Both PTX3 and sTWEAK levels associated with the endothelial dysfunction observed with progressive
kidney failure. Additionally, both biomarkers impacted the predictability of cardiovascular
outcomes
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Google Scholar:Yilmaz, Mahmut Ilker Lker
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Sönmez, Alper
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Ortiz Arduán, Alberto
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Saǧlam, Mutlu
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Kílíç, Selim S.
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Eyileten, Tayfun
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Çaǧlar, Kayser
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Oǧuz, Yusuf
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Vural, Abdülgaffar
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Çakar, Mustafa
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Egido de los Ríos, Jesús
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Altun, Battal
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Yenicesu, Müjdat
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Blanco-Colio, Luís Miguel
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Carrero, Juan Jesús
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