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Lower urinary connective tissue growth factor levels and incident CKD stage 3 in the general population.

Publication ,  Journal Article
O'Seaghdha, CM; Hwang, S-J; Bhavsar, NA; Köttgen, A; Coresh, J; Astor, BC; Fox, CS
Published in: Am J Kidney Dis
June 2011

BACKGROUND: Connective tissue growth factor (CTGF) is involved in the development and progression of kidney diseases, including diabetic nephropathy and kidney fibrosis, but also may have a role in mesangial repair after injury. It is unknown whether, in the general population, urinary CTGF levels are associated with a decrease in estimated glomerular filtration rate (eGFR) to <60 mL/min/1.73 m(2) (ie, development of chronic kidney disease [CKD] stage 3). STUDY DESIGN: Nested case-control. SETTING & PARTICIPANTS: 100 cases of incident CKD stage 3 and 100 age-and sex-matched controls in the Framingham Heart Study; 141 cases and 135 age-, sex-, and race-matched controls in the Atherosclerosis Risk in Communities (ARIC) Study. Controls had eGFR ≥60 mL/min/1.73 m(2) at follow-up in both studies. PREDICTORS: Urinary CTGF concentrations. OUTCOMES: Incident CKD stage 3, defined as eGFR <60 mL/min/1.73 m(2). MEASUREMENTS: Stored urine samples from Framingham Heart Study and ARIC were measured for CTGF. Covariates were obtained from Framingham Heart Study and ARIC participant examinations. RESULTS: In the Framingham Heart Study, the median baseline urinary CTGF concentration was lower in cases (1.35 ng/mL) than controls (2.35 ng/mL; paired t test, P < 0.0001). The multivariable-adjusted OR for incident CKD stage 3 was 0.33 (95% CI, 0.17-0.64; P < 0.001) per 1-standard deviation in log urinary CTGF level after adjustment for CKD risk factors, baseline eGFR, and baseline log urinary albumin-creatinine ratio, with similar results in participants without diabetes (n = 184). Results were not materially different when urinary CTGF level was indexed to urinary creatinine level (multivariable-adjusted OR, 0.34; 95% CI, 0.21-0.56; P < 0.001). A similar, but nonsignificant, trend of risk of incident CKD stage 3 with lower baseline urinary CTGF concentration was observed in an independent case-control study conducted in the ARIC Study, with the strongest results observed in participants free of diabetes. This inverse relationship was robust in meta-analysis of both the overall and diabetes-free groups. LIMITATIONS: Observational study; causality cannot be inferred. CONCLUSIONS: Lower urinary CTGF concentrations precede the onset of CKD stage 3 in the general population. Further work is required to fully characterize how CTGF level influences risk of CKD.

Duke Scholars

Published In

Am J Kidney Dis

DOI

EISSN

1523-6838

Publication Date

June 2011

Volume

57

Issue

6

Start / End Page

841 / 849

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • United States
  • Severity of Illness Index
  • Prospective Studies
  • Prognosis
  • Population Surveillance
  • Nephelometry and Turbidimetry
  • Middle Aged
  • Male
  • Kidney Failure, Chronic
 

Citation

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O’Seaghdha, C. M., Hwang, S.-J., Bhavsar, N. A., Köttgen, A., Coresh, J., Astor, B. C., & Fox, C. S. (2011). Lower urinary connective tissue growth factor levels and incident CKD stage 3 in the general population. Am J Kidney Dis, 57(6), 841–849. https://doi.org/10.1053/j.ajkd.2010.11.022
O’Seaghdha, Conall M., Shih-Jen Hwang, Nrupen A. Bhavsar, Anna Köttgen, Josef Coresh, Brad C. Astor, and Caroline S. Fox. “Lower urinary connective tissue growth factor levels and incident CKD stage 3 in the general population.Am J Kidney Dis 57, no. 6 (June 2011): 841–49. https://doi.org/10.1053/j.ajkd.2010.11.022.
O’Seaghdha CM, Hwang S-J, Bhavsar NA, Köttgen A, Coresh J, Astor BC, et al. Lower urinary connective tissue growth factor levels and incident CKD stage 3 in the general population. Am J Kidney Dis. 2011 Jun;57(6):841–9.
O’Seaghdha, Conall M., et al. “Lower urinary connective tissue growth factor levels and incident CKD stage 3 in the general population.Am J Kidney Dis, vol. 57, no. 6, June 2011, pp. 841–49. Pubmed, doi:10.1053/j.ajkd.2010.11.022.
O’Seaghdha CM, Hwang S-J, Bhavsar NA, Köttgen A, Coresh J, Astor BC, Fox CS. Lower urinary connective tissue growth factor levels and incident CKD stage 3 in the general population. Am J Kidney Dis. 2011 Jun;57(6):841–849.
Journal cover image

Published In

Am J Kidney Dis

DOI

EISSN

1523-6838

Publication Date

June 2011

Volume

57

Issue

6

Start / End Page

841 / 849

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • United States
  • Severity of Illness Index
  • Prospective Studies
  • Prognosis
  • Population Surveillance
  • Nephelometry and Turbidimetry
  • Middle Aged
  • Male
  • Kidney Failure, Chronic