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Olle Melander

Principal investigator

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Soluble Urokinase-type Plasminogen Activator Receptor (suPAR) and Impaired Kidney Function in the Population-based Malmö Diet and Cancer Study

Author

  • Christina-Alexandra Schulz
  • Margaretha Persson
  • Anders Christensson
  • George Hindy
  • Peter Almgren
  • Peter M Nilsson
  • Olle Melander
  • Gunnar Engström
  • Marju Orho-Melander

Summary, in English

INTRODUCTION: The soluble urokinase-type plasminogen activator receptor (suPAR) has recently been associated with a decline in kidney function and incidence of chronic kidney disease in patients with cardiovascular disease undergoing cardiac catheterization, yet little is known whether suPAR is associated with deterioration of kidney function in the general population.

METHODS: In the population-based Malmö Diet and Cancer Study cohort, plasma levels of suPAR were quantified in 5381 participants at baseline (1991-1994), and creatinine was measured and used to calculate estimated glomerulus filtration rate (eGFR) at baseline and follow-up (2007-2012). Incident chronic kidney disease was defined as eGFR < 60 ml/min per 1.73 m2 at follow-up.

RESULTS: Participants within the highest quartile of suPAR had a significantly lower mean eGFR at follow-up than those within the lowest quartile (mean 68 vs. 74 ml/min per 1.73 m2; P-trend = 4.3 × 10-7). In multivariate regression analysis, suPAR (per 1 SD increment of log-transformed suPAR) was associated with a decline in eGFR (P = 3.3 × 10-9) and incident chronic kidney disease (561 events, odds ratio = 1.25; 95% confidence interval, 1.10-1.41). Furthermore, we identified 110 cases of hospitalization due to impaired kidney function via linkage to national registers of inpatient and outpatient hospital diagnoses. During a mean follow-up time of 19 years, suPAR was associated with risk for hospitalization due to impaired kidney function (hazard ratio = 1.49; 95% confidence interval, 1.27-1.74) in multivariate Cox proportional hazard analysis.

DISCUSSION: The increased suPAR level at baseline was associated with a significantly higher longitudinal decline in eGFR, higher incidence of chronic kidney disease, and hospitalization due to impaired kidney function in a cohort of healthy middle-aged participants.

Department/s

  • Diabetes - Cardiovascular Disease
  • Internal Medicine - Epidemiology
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • Cardiovascular Research - Hypertension
  • Genomics, Diabetes and Endocrinology
  • Cardiovascular Research - Epidemiology

Publishing year

2017-03

Language

English

Pages

239-247

Publication/Series

Kidney International Reports

Volume

2

Issue

2

Document type

Journal article

Publisher

Elsevier Inc.

Topic

  • Cardiac and Cardiovascular Systems
  • Urology and Nephrology

Status

Published

Research group

  • Diabetes - Cardiovascular Disease
  • Internal Medicine - Epidemiology
  • Cardiovascular Research - Hypertension
  • Genomics, Diabetes and Endocrinology
  • Cardiovascular Research - Epidemiology

ISBN/ISSN/Other

  • ISSN: 2468-0249