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Soluble TWEAK and PTX3 in nondialysis CKD patients: impact on endothelial dysfunction and cardiovascular outcomes.
Clin J Am Soc Nephrol. 2011 Apr; 6(4):785-92.CJ

Abstract

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.

Authors+Show Affiliations

Department of Nephrology, Gu¨lhane School of Medicine, Ankara, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21330486

Citation

Yilmaz, Mahmut Ilker, et al. "Soluble TWEAK and PTX3 in Nondialysis CKD Patients: Impact On Endothelial Dysfunction and Cardiovascular Outcomes." Clinical Journal of the American Society of Nephrology : CJASN, vol. 6, no. 4, 2011, pp. 785-92.
Yilmaz MI, Sonmez A, Ortiz A, et al. Soluble TWEAK and PTX3 in nondialysis CKD patients: impact on endothelial dysfunction and cardiovascular outcomes. Clin J Am Soc Nephrol. 2011;6(4):785-92.
Yilmaz, M. I., Sonmez, A., Ortiz, A., Saglam, M., Kilic, S., Eyileten, T., Caglar, K., Oguz, Y., Vural, A., Çakar, M., Egido, J., Altun, B., Yenicesu, M., Blanco-Colio, L. M., & Carrero, J. J. (2011). Soluble TWEAK and PTX3 in nondialysis CKD patients: impact on endothelial dysfunction and cardiovascular outcomes. Clinical Journal of the American Society of Nephrology : CJASN, 6(4), 785-92. https://doi.org/10.2215/CJN.09231010
Yilmaz MI, et al. Soluble TWEAK and PTX3 in Nondialysis CKD Patients: Impact On Endothelial Dysfunction and Cardiovascular Outcomes. Clin J Am Soc Nephrol. 2011;6(4):785-92. PubMed PMID: 21330486.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Soluble TWEAK and PTX3 in nondialysis CKD patients: impact on endothelial dysfunction and cardiovascular outcomes. AU - Yilmaz,Mahmut Ilker, AU - Sonmez,Alper, AU - Ortiz,Alberto, AU - Saglam,Mutlu, AU - Kilic,Selim, AU - Eyileten,Tayfun, AU - Caglar,Kayser, AU - Oguz,Yusuf, AU - Vural,Abdulgaffar, AU - Çakar,Mustafa, AU - Egido,Jesus, AU - Altun,Battal, AU - Yenicesu,Mujdat, AU - Blanco-Colio,Luis Miguel, AU - Carrero,Juan Jesús, Y1 - 2011/02/17/ PY - 2011/2/19/entrez PY - 2011/2/19/pubmed PY - 2011/8/19/medline SP - 785 EP - 92 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 6 IS - 4 N2 - 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. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/21330486/Soluble_TWEAK_and_PTX3_in_nondialysis_CKD_patients:_impact_on_endothelial_dysfunction_and_cardiovascular_outcomes_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=21330486 DB - PRIME DP - Unbound Medicine ER -