TY - JOUR
T1 - Estimated Glomerular Filtration Rate and Albuminuria Are Associated with Biomarkers of Cardiac Injury in a Population-Based Cohort Study
T2 - The Maastricht Study
AU - Martens, Remy J. H.
AU - Kimenai, Dorien M.
AU - Kooman, Jeroen P.
AU - Stehouwer, Coen D. A.
AU - Tan, Frans E. S.
AU - Bekers, Otto
AU - Dagnelie, Pieter C.
AU - van der Kallen, Carla J. H.
AU - Kroon, Abraham A.
AU - Leunissen, Karel M. L.
AU - van der Sande, Frank M.
AU - Schaper, Nicolaas C.
AU - Sep, Simone J. S.
AU - Schram, Miranda T.
AU - van Suijlen, Jeroen D.
AU - van Dieijen-Visser, Marja P.
AU - Meex, Steven J. R.
AU - Henry, Ronald M. A.
PY - 2017/4
Y1 - 2017/4
N2 - BACKGROUND: Chronic kidney disease (CKD) is associated with an increased cardiovascular disease mortality risk. It is, however, less clear at what point in the course from normal kidney function to CKD the association with cardiovascular disease appears. Studying the associations of estimated glomerular filtration rate (eGFR) and albuminuria with biomarkers of (subclinical) cardiac injury in a population without substantial CKD may clarify this issue.METHODS: We examined the cross-sectional associations of eGFR and urinary albumin excretion (UAE) with high-sensitivity cardiac troponin (hs-cTn) T, hs-cTnI, and N-terminal probrain natriuretic-peptide (NT-proBNP) in 3103 individuals from a population-based diabetes-enriched cohort study.RESULTS: After adjustment for potential confounders, eGFR and UAE were associated with these biomarkers of cardiac injury, even at levels that do not fulfill the CKD criteria. For example, eGFR 60-= 90 mL . min(-1) . (1.73 m(2))(-1)] was associated with a [ratio (95% CI)] 1.21 (1.17-1.26), 1.14 (1.07-1.20), and 1.19 (1.12-1.27) times higher hscTnT, hs-cTnI, and NT-proBNP, respectively. The association of eGFR with hs-cTnT was statistically significantly stronger than that with hs-cTnI. In addition, UAE 15-CONCLUSIONS: eGFR and albuminuria were already associated with biomarkers of (subclinical) cardiac injury at levels that do not fulfill the CKD criteria. Although reduced renal elimination may partly underlie the associations of eGFR, these findings support the concept that eGFR and albuminuria are, over their entire range, associated with cardiac injury. (C) 2016 American Association for Clinical Chemistry
AB - BACKGROUND: Chronic kidney disease (CKD) is associated with an increased cardiovascular disease mortality risk. It is, however, less clear at what point in the course from normal kidney function to CKD the association with cardiovascular disease appears. Studying the associations of estimated glomerular filtration rate (eGFR) and albuminuria with biomarkers of (subclinical) cardiac injury in a population without substantial CKD may clarify this issue.METHODS: We examined the cross-sectional associations of eGFR and urinary albumin excretion (UAE) with high-sensitivity cardiac troponin (hs-cTn) T, hs-cTnI, and N-terminal probrain natriuretic-peptide (NT-proBNP) in 3103 individuals from a population-based diabetes-enriched cohort study.RESULTS: After adjustment for potential confounders, eGFR and UAE were associated with these biomarkers of cardiac injury, even at levels that do not fulfill the CKD criteria. For example, eGFR 60-= 90 mL . min(-1) . (1.73 m(2))(-1)] was associated with a [ratio (95% CI)] 1.21 (1.17-1.26), 1.14 (1.07-1.20), and 1.19 (1.12-1.27) times higher hscTnT, hs-cTnI, and NT-proBNP, respectively. The association of eGFR with hs-cTnT was statistically significantly stronger than that with hs-cTnI. In addition, UAE 15-CONCLUSIONS: eGFR and albuminuria were already associated with biomarkers of (subclinical) cardiac injury at levels that do not fulfill the CKD criteria. Although reduced renal elimination may partly underlie the associations of eGFR, these findings support the concept that eGFR and albuminuria are, over their entire range, associated with cardiac injury. (C) 2016 American Association for Clinical Chemistry
KW - CHRONIC KIDNEY-DISEASE
KW - ACUTE MYOCARDIAL-INFARCTION
KW - STAGE RENAL-DISEASE
KW - TROPONIN-T
KW - NATRIURETIC PEPTIDE
KW - CYSTATIN C
KW - CARDIOVASCULAR-DISEASE
KW - DIABETIC-NEPHROPATHY
KW - NONDIALYSIS PATIENTS
KW - NT-PROBNP
U2 - 10.1373/clinchem.2016.266031
DO - 10.1373/clinchem.2016.266031
M3 - Article
C2 - 28213568
VL - 63
SP - 887
EP - 897
JO - Clinical Chemistry
JF - Clinical Chemistry
SN - 0009-9147
IS - 4
ER -