scholarly journals Relationship between Plasma Proprotein Convertase Subtilisin/Kexin Type 9 and Estimated Glomerular Filtration Rate in the General Chinese Population

2018 ◽  
Vol 8 (4) ◽  
pp. 311-320 ◽  
Author(s):  
Hui-Wen Zhang ◽  
Xi Zhao ◽  
Rui-Xia Xu ◽  
Yuan-Lin Guo ◽  
Cheng-Gang Zhu ◽  
...  

Background: Elevated levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) have been reported to be related to dyslipidemia, including patients with kidney dysfunction. However, its association with estimated glomerular filtration rate (eGFR) in individuals with normal serum creatinine (SCr) has not been determined. Methods: A total of 2,089 subjects with normal SCr and without lipid-lowering treatment were consecutively enrolled in this study. Plasma PCSK9 levels were measured by ELISA kit and eGFR was evaluated by the Chronic Kidney Disease Epidemiology Collaboration equation. Subjects were divided into a normal eGFR group (n = 1,205, ≥90 mL/min/1.73 m2) and a decreased eGFR group (n = 884, < 90 mL/min/1.73 m2). Baseline characteristics and laboratory findings were compared between the two groups. Spearman’s correlation and linear regression were performed to determine the association between PCSK9 and eGFR. Results: No significant difference in PCSK9 levels was found between the normal eGFR group and the decreased eGFR group (236.84 ± 67.87 vs. 239.98 ± 68.72 ng/mL, p = 0.303). In Spearman’s correlation and multivariable linear regression analysis, no association of PCSK9 levels with eGFR was detected in the total cohort (r = –0.039, p = 0.079; adjusted β = –0.013, p = 0.630). This result remained the same in the subgroups of normal eGFR (r = –0.038, p = 0.190; adjusted β = –0.031, p = 0.367) and decreased eGFR (r = –0.054, p = 0.109; adjusted β = –0.034, p = 0.319). Conclusion: In this single-center study with moderate sample size, the data showed no relationship of PCSK9 levels with normal or decreased eGFR in untreated patients with normal SCr, suggesting that further studies may be needed to understand the relationship between PCSK9 and lipid disorder in different stage of kidney dysfunction.

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
James Shepherd ◽  
Chuan-Chuan Wun ◽  
Daniel J Wilson ◽  
Andrea L Zuckerman

We previously demonstrated a dose-dependent improvement in renal function and reduction in cardiovascular risk in TNT with intensive lipid lowering with atorvastatin (ATV) 80 mg vs 10 mg. This post hoc analysis examines the relationship between the observed improvement in estimated glomerular filtration rate (eGFR) and reduction of major cardiovascular events (MCVE). After 8 weeks open-label therapy with ATV 10 mg, 10,001 patients with CHD were randomized to double-blind therapy with either ATV 10 or 80 mg. Patients were followed for a median of 4.9 years for the occurrence of MCVEs (CHD death, nonfatal MI, and stroke). The relationship between change from baseline eGFR (using the MDRD equation) at the final visit prior to a MCVE and the risk of MCVE was assessed using a Cox proportional hazards model adjusting for baseline eGFR and other baseline characteristics. Of 9656 patients with complete renal data, 156 had a MCVE before follow-up eGFR assessment and were excluded. In the remaining 9500 patients, mean baseline eGFR was 65.3 mL/min/1.73 m 2 and mean change from baseline was 4.3 mL/min/1.73 m 2 . This represented a reduction in the risk of MCVE of 2.7% per mL increase in eGFR (HR 0.973, 95% CI 0.967– 0.980, P <0.0001). This association remained significant in patients with eGFR <60 and those with eGFR ≥60 mL/min/1.73 m 2 at baseline, with no significant interaction between eGFR change and baseline renal status ( P =0.98). A 5 mL/min on-treatment improvement in eGFR was associated with a 12.6% reduction in MCVE, while a 5 mL/min reduction was associated with a 14.4% increase in MCVE. Mean change from baseline eGFR was 3.5 mL/min/1.73 m 2 with ATV 10 mg and 5.2 mL/min/1.73 m 2 with ATV 80 mg, representing significant 9.3% and 12.4% reductions in risk, respectively. Analysis of interaction between treatment and eGFR change for prediction of MCVE demonstrated a stronger association between eGFR change and MCVE in the ATV 80 mg treatment group ( P =0.011). Improvement in eGFR was highly associated with a reduction in MCVE, irrespective of baseline renal function. This relationship was dose dependent. Improvement in eGFR may be a biomarker for the response to atorvastatin, and for the stabilization of atherosclerotic cardiovascular disease.


2019 ◽  
Vol 47 (4) ◽  
pp. 1417-1428
Author(s):  
Letao Lin ◽  
Xinfei Li ◽  
Haitao Guan ◽  
Jian Wang ◽  
Xiaoqiang Tong ◽  
...  

Objective The present study aimed to evaluate renal function, complications, and changes in tumor size after transarterial embolization for patients with renal angiomyolipomas. Methods We performed a meta-analysis of transarterial embolization in patients with renal angiomyolipomas from January 1994 to April 2018. Endpoints of interest were the estimated glomerular filtration rate, serum creatinine levels, blood urea nitrogen levels, complications, and reduction of tumors. Results A total of 30 studies comprising 653 patients were included. A total of 32.0% of patients were treated by urgent transarterial embolization for spontaneous ruptured renal angiomyolipomas. Other patients sought to relieve symptoms or received embolism prophylactically. The estimated glomerular filtration rate showed no significant difference between before and after embolization. In 363 patients with data on complications, post-embolization syndrome occurred most frequently (54.0%). Only 16 (4.4%) patients had major complications. The diameter of sporadic angiomyolipomas was reduced by a mean of 2.09 cm (95% confidence interval [CI], 0.73–3.45 cm; I2 = 29.3%) and they were reduced in size by 30.0% (95% CI, 16.0%–44.0%; I2 = 27.9%). Conclusions Transarterial embolization of renal angiomyolipomas affects renal function preservation, with a low complication rate. Transarterial embolization is useful for sporadic and tuberous sclerosis complex-related angiomyolipomas.


2021 ◽  
Vol 15 (11) ◽  
pp. 3293-3295
Author(s):  
Ishtiaq Alam ◽  
Faheem Usman Sulehri ◽  
Muhammad Abdul Azim Baig ◽  
Maira Bhatti ◽  
Fouzia Perveen ◽  
...  

Background: Chronic kidney disease (CKD), is defined as progressive loss in kidney function. The study evaluated the mean change in estimated glomerular filtration rate (eGFR) with febuxostat in patients of advanced chronic kidney dysfunction with hyperuricemia. Methodology: A prospective observational study was conducted at the department of Nephrology, Sheikh Zayed Hospital, Lahore for 6 months, from January 2019 to October 2019. At baselines, the blood sample was obtained and sent to the laboratory for assessment of serum creatinine level. The eGFR was calculated by using the MDRD formula. Patients were then advised to take one oral Febuxostat 40 mg daily for 6 months. After 6 months, the blood sample was obtained for assessment of serum creatinine level. Results: The mean age of the patients was 40.72±14.90 years, male to female ratio was 1:1. The mean value of eGFR at baseline was 23.53±11.09 and its mean value at 6th month was 34.28+12.31, which was significant (p<0.001). Conclusion: Febuxostat effectively improved estimated glomerular filtration rate (eGFR) in patients presenting with advanced chronic kidney dysfunction with hyperuricemia. Keywords: Hyperuricemia, Kidney, Disease, Febuxostat, Dysfunction, Glomerular, Filtration


Author(s):  
Luana Bojko ◽  
Gustavo de Paula Ripka ◽  
Laura Mattana Dionísio ◽  
Celso Luiz Borges ◽  
Danielle Cristyane Kalva Borato ◽  
...  

The estimated glomerular filtration rate is a rather important measurement for patients under intensive care, since they often receive several drugs, and impaired renal function may result in misleading dosing. The estimated glomerular filtration is derived from mathematical models using serum creatinine, a measurement that suffers interference of some drugs, such as metamizole. The study intented to evaluate the impact on patient stratification for dose adjustment of two antimicrobials (meropenem and vancomycin) caused by metamizole interference in creatinine measurement by dry chemistry. A cross-sectional study was conducted with a group of 108 hospitalized patients under metamizole prescriptions at fixed intervals. Serum creatinine levels were determined by enzymatic dry chemistry and Jaffé assays and the estimated glomerular filtration rate was calculated through the CKD-EPI equation. Patients were stratified in groups according to their estimated glomerular filtration rate for drug dosing of vancomycin and meropenem. As expected, creatinine values were significantly lower in measurements performed by the dry chemistry method in comparison to Jaffé assay (p<0.0001) when patients are under metamizole treatment. A significant bias (-40.3%) was observed between those two methods, leading to a significant difference (p<0.0001) in patient classification according to renal function using the CKD-EPI equation for dosing adjustment. Thus, during the validity of metamizole treatment, the stratification for drug dosing by the estimated glomerular filtration rate is not reliable if the creatinine measurement is done through dry chemistry. Clinical and laboratory staff must be aware of these limitations and cooperate to optimize pharmacotherapy.


Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 18
Author(s):  
Chi Qin ◽  
Hailong Jin ◽  
Haixiang Zhang ◽  
Yun Zhang ◽  
Zhaojie Guan ◽  
...  

The purpose of this study was to evaluate the feasibility of the combination of point-shear wave elastography (p-SWE) and estimated glomerular filtration rate (eGFR) for assessing different stages of interstitial fibrosis and tubular atrophy (IF/TA) in patients with chronic renal allograft dysfunction (CAD). From September 2020 to August 2021, 47 patients who underwent renal biopsy and p-SWE examinations were consecutively enrolled in this study. The areas under the receiver operating characteristic curves (AUCs) were calculated to evaluate overall accuracy and to identify the optimal cutoff values for different IF/TA stages. A total of 43 patients were enrolled in this study. The renal cortical stiffness and eGFR showed a significant difference between IF/TA Grade 0–1 and Grade 2–3 (p < 0.001). Additionally, renal stiffness and eGFR were independent predictors for moderate-to-severe IF/TA (Grade ≥ 2) according to multiple logistic regression analysis. The combination of p-SWE and eGFR, with an optimal cutoff value of −1.63, was superior to eGFR alone in assessing moderate-to-severe interstitial fibrosis (AUC, 0.86 vs. 0.72, p = 0.02) or tubular atrophy (AUC, 0.88 vs. 0.74, p = 0.02). There was no difference between p-SWE and eGFR in assessing moderate-to-severe IF/TA (AUC, 0.85 vs. 0.79, p = 0.61). Therefore, combining p-SWE and eGFR is worthy of clinical popularization and application.


2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Kunimi Maeda ◽  
Chieko Hamada ◽  
Satoshi Horikoshi ◽  
Yasuhiko Tomino

Purpose. To explore factors contributing to chronic kidney disease (CKD) progression and change in estimated glomerular filtration rate over time (ΔeGFR) as a risk factor in predialysis patients under multidisciplinary managements. Methods. Among 113 CKD patients, eGFR, serum creatinine, total protein, albumin, urea nitrogen, uric acid, calcium, inorganic phosphate, total cholesterol, urinary creatinine, urinary protein (UP), hemoglobin A1c, hemoglobin, and hematocrit were analyzed. Results. ΔeGFR analysis in the first six months presented a positive slope (remission group) in 43 patients (38%) and a negative slope (no-remission group) in 70 patients (62%). Three-year dialysis-free rate was 89.4% in the remission group and 39.3% in the no-remission group, with a significant difference (). To explore factors contributing to dialysis initiation by stepwise Cox regression, baseline eGFR (HR 0.706, ) and ΔeGFR in the first six months of treatment (HR 0.075, ) were identified. To investigate factors affecting remission and no remission by stepwise logistic regression, age (odds ratio 1.06, ) and UP excretion (odds ratio 1.223, ) were identified. Conclusion. Monitoring of ΔeGFR and UP is not only useful in suppressing CKD 3 progression, but also in deciding strategies to achieve remission in individual patients.


2014 ◽  
Vol 29 (1-2) ◽  
pp. 12-16
Author(s):  
Sharmin Jahan ◽  
Rokeya Begum ◽  
Qazi Shamima Akhter

Background: Stroke is one of the commonest causes of severe disability and accounts for a large proportion of health care resources. Kidney diseases are related to stroke and reduced estimated glomerular filtration rate (eGFR) appears to be a significant independent prognostic factor for short as well as long term mortality in stroke patients. Objective: The present study has been designed to assess the relationship between stroke and kidney dysfunction based on eGFR. Methods: The present study was a case control study. The study was conducted in the Department of Physiology, Dhaka Medical College and Hospital (DMCH), Dhaka from 1st July 2010 to 30th June 2011. A total of 200 subjects were included with the age limit of 35–85 years. Out of them 100 apparently healthy subjects were selected as control(Group A) for comparison and 100 diagnosed stroke patients were selected as study group (Group B). On the basis of age, group A and group B were further subdivided into group A1(age 35-59 years) consisting of 47 normal persons and group A2(age 60-85 years) consisting of 53 normal person, group B1(age35-59 years) was consisting of 42 stroke patients and group B2(60-85 years) consisting of 58 stroke patients .The study subjects were selected from admitted patients in Department of Medicine, DMCH, Dhaka. Estimated GFR (eGFR) were measured by MDRD equation. The data was analyzed by computer based statistical software (SPSS version 12). Results: The result was expressed as Mean (+SD). The test of significance was calculated and p values <0.05 was accepted as level of significance. The mean(±SD)of eGFR level was significantly(p<0.001) lower in group B1 and B2 than that of group A1 and A2 respectively.Conclusion: From this study it can be concluded that, stroke patients suffers from kidney dysfunction than that of normal control group on the basis of measuring eGFR.http://dx.doi.org/10.3329/bjpp.v29i1-2.20062 Bangladesh J Physiol Pharmacol 2013; 29(1&2) : 12-16 


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