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Photo: KG Pressfoto

Marju Orho-Melander


Photo: KG Pressfoto

Growth differentiation factor-15 and incident chronic kidney disease : a population-based cohort study


  • Xue Bao
  • Biao Xu
  • Yan Borné
  • Marju Orho-Melander
  • Olle Melander
  • Jan Nilsson
  • Anders Christensson
  • Gunnar Engström

Summary, in English

Background: The relationship between growth differentiation factor 15 (GDF-15) and the development of chronic kidney disease (CKD) is still unclear. We sought to examine whether plasma GDF-15 was related to incident CKD and kidney function decline using a large prospective cohort study. Methods: 4318 participants of the Malmö Diet and Cancer Study-Cardiovascular Cohort were examined in 1991-1994. Incidence of CKD was followed prospectively by linkage with national patient registers. Estimated glomerular filtration rate (eGFR) was available for all participants at baseline, and was re-measured in a subgroup of 2744 subjects after 16.6 ± 1.49 years. Incidence of CKD was examined in relation to GDF-15 using Cox regression analysis. Logistic regression was used to examine the association of GDF-15 with eGFR change and eGFR-based CKD. Models were carefully corrected for potential confounders including baseline eGFR, N-terminal pro-B-type natriuretic peptide, and competing risk from death. Results: 165 patients developed CKD after 19.2 ± 4.04 years of follow-up. The adjusted hazard ratio (95% confidence interval, CI) for CKD in 4th versus 1st quartile of GDF-15 was 2.37 (1.33, 4.24) (p for trend < 0.01). Each per 1 standard deviation increase in GDF-15 was associated with a decline in eGFR of − 0.97 mL/min/1.73 m2 (95% CI, − 1.49 ~ − 0.45; p < 0.001). GDF-15 was also significantly associated eGFR-based CKD in 2713 subjects with baseline eGFR ≥60 mL/min/1.73 m2. Conclusions: GDF-15 predicted incidence of CKD and eGFR decline in the general population, independent of a wide range of potential risk factors and competing risk of death.


  • Cardiovascular Research - Epidemiology
  • Nutrition Epidemiology
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health
  • Diabetes - Cardiovascular Disease
  • Cardiovascular Research - Hypertension
  • Hepato-Pancreato-Biliary Surgery
  • Surgery (Lund)
  • Internal Medicine - Epidemiology

Publishing year





BMC Nephrology





Document type

Journal article


BioMed Central (BMC)


  • Urology and Nephrology


  • Chronic kidney disease
  • Cohort study
  • Competing risk
  • Estimated glomerular filtration rate
  • Growth differentiation factor 15



Research group

  • Cardiovascular Research - Epidemiology
  • Nutrition Epidemiology
  • Diabetes - Cardiovascular Disease
  • Cardiovascular Research - Hypertension
  • Hepato-Pancreato-Biliary Surgery
  • Internal Medicine - Epidemiology


  • ISSN: 1471-2369