Plasma endostatin predicts kidney outcomes in patients with type 2 diabetes

Kinsuk Chauhan, Divya Anna Verghese, Veena Rao, Lili Chan, Chirag Parikh, Steven G. Coca, Girish N. Nadkarni

Research output: Contribution to journalArticle

Abstract

Novel biomarkers are needed to predict kidney function decline in patients with type 2 diabetes, especially those with preserved glomerular filtration rate (GFR). There are limited data on the association of markers of endothelial dysfunction with longitudinal GFR decline. We used banked specimens from a nested case-control study in the Action to Control Cardiovascular Disease (ACCORD) trial (n=187 cases: 187 controls) and from a diverse contemporary cohort of type 2 diabetic patients from the Mount Sinai BioMe Biobank (n=871) to assess the association of plasma endostatin and kidney outcomes. We measured plasma endostatin at enrollment and examined its association with a composite kidney outcome of sustained 40% decline in estimated GFR or end-stage renal disease. Baseline plasma endostatin levels were higher in participants with the composite outcome. Each log2 increment in plasma endostatin was associated with approximately 2.5-fold higher risk of the kidney outcome (adjusted odds ratio [OR] 2.5; 95% confidence interval [CI] 1.5-4.3 in ACCORD and adjusted hazard ratio [HR] 2.6; 95% CI 1.8-3.8 in BioMe). Participants in the highest vs. lowest quartile of plasma endostatin had approximately four-fold higher risk for the kidney outcome (adjusted OR 3.6; 95% CI 1.8-7.3 in ACCORD and adjusted HR 4.4; 95% CI 2.3-8.5 in BioMe). The AUC for the kidney outcome improved from 0.74 to 0.77 in BioMe with the addition of endostatin to a base clinical model. Plasma endostatin was strongly associated with kidney outcomes in type 2 diabetics with preserved eGFR and improved risk discrimination over traditional predictors.

Original languageEnglish (US)
Pages (from-to)439-446
Number of pages8
JournalKidney International
Volume95
Issue number2
DOIs
StatePublished - Feb 1 2019
Externally publishedYes

Keywords

  • albuminuria
  • chronic kidney disease
  • inflammation
  • kidney injury
  • risk stratification

ASJC Scopus subject areas

  • Nephrology

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  • Cite this

    Chauhan, K., Verghese, D. A., Rao, V., Chan, L., Parikh, C., Coca, S. G., & Nadkarni, G. N. (2019). Plasma endostatin predicts kidney outcomes in patients with type 2 diabetes. Kidney International, 95(2), 439-446. https://doi.org/10.1016/j.kint.2018.09.019