TY - JOUR
T1 - Urinary kidney injury molecule 1 (KIM-1) and interleukin 18 (IL-18) as risk markers for heart failure in older adults
T2 - The health, aging, and body composition (Health ABC) study
AU - Driver, Todd H.
AU - Katz, Ronit
AU - Ix, Joachim H.
AU - Magnani, Jared W.
AU - Peralta, Carmen A.
AU - Parikh, Chirag R.
AU - Fried, Linda
AU - Newman, Anne B.
AU - Kritchevsky, Stephen B.
AU - Sarnak, Mark J.
AU - Shlipak, Michael G.
N1 - Funding Information:
Support: Drs Shlipak, Sarnak, Ix, and Katz were supported by NIA grant 5R01AG027002-07 . Mr Driver was supported by UCSF-CTSI grant TL1 TR000144 . Drs Newman and Kritchevsky were supported by NIA contracts N01-AG-6-2101, N01-AG-6-2103, and N01-AG-6-2106 ; NIA grant R01-AG028050 ; and National Institute of Nursing Research grant R01-NR012459 . The study sponsors had no role in study design; collection, analysis, and interpretation of the data; writing the report; and the decision to submit the report for publication.
PY - 2014/7
Y1 - 2014/7
N2 - Background Kidney damage and reduced kidney function are potent risk factors for heart failure, but existing studies are limited to assessing albuminuria or estimated glomerular filtration rate (eGFR). We evaluated the associations of levels of urinary biomarkers of kidney tubular injury (interleukin 18 [IL-18] and kidney injury molecule 1 [KIM-1]) with future risk of heart failure. Study Design Retrospective cohort study. Setting & Participants 2,917 participants without heart failure in the Health, Aging, and Body Composition (Health ABC) cohort. Predictors Ratios of urine KIM-1, IL-18, and albumin to creatinine (KIM-1:Cr, IL-18:Cr, and ACR, respectively). Outcomes Incident heart failure over a median follow-up of 12 years. Results Median values of each marker at baseline were 812 (IQR, 497-1,235) pg/mg for KIM-1:Cr, 31 (IQR, 19-56) pg/mg for IL-18:Cr, and 8 (IQR, 5-19) mg/g for ACR. 596 persons developed heart failure during follow-up. The top quartile of KIM-1:Cr was associated with risk of incident heart failure after adjustment for baseline eGFR, heart failure risk factors, and ACR (HR, 1.32; 95% CI, 1.02-1.70) in adjusted multivariate proportional hazards models. The top quartile of IL-18:Cr also was associated with heart failure in a model adjusted for risk factors and eGFR (HR, 1.35; 95% CI, 1.05-1.73), but was attenuated by adjustment for ACR (HR, 1.15; 95% CI, 0.89-1.48). The top quartile of ACR had a stronger adjusted association with heart failure (HR, 1.96; 95% CI, 1.53-2.51). Limitations Generalizability to other populations is uncertain. Conclusions Higher urine KIM-1 concentrations were associated independently with incident heart failure risk, although the associations of higher ACR were of stronger magnitude.
AB - Background Kidney damage and reduced kidney function are potent risk factors for heart failure, but existing studies are limited to assessing albuminuria or estimated glomerular filtration rate (eGFR). We evaluated the associations of levels of urinary biomarkers of kidney tubular injury (interleukin 18 [IL-18] and kidney injury molecule 1 [KIM-1]) with future risk of heart failure. Study Design Retrospective cohort study. Setting & Participants 2,917 participants without heart failure in the Health, Aging, and Body Composition (Health ABC) cohort. Predictors Ratios of urine KIM-1, IL-18, and albumin to creatinine (KIM-1:Cr, IL-18:Cr, and ACR, respectively). Outcomes Incident heart failure over a median follow-up of 12 years. Results Median values of each marker at baseline were 812 (IQR, 497-1,235) pg/mg for KIM-1:Cr, 31 (IQR, 19-56) pg/mg for IL-18:Cr, and 8 (IQR, 5-19) mg/g for ACR. 596 persons developed heart failure during follow-up. The top quartile of KIM-1:Cr was associated with risk of incident heart failure after adjustment for baseline eGFR, heart failure risk factors, and ACR (HR, 1.32; 95% CI, 1.02-1.70) in adjusted multivariate proportional hazards models. The top quartile of IL-18:Cr also was associated with heart failure in a model adjusted for risk factors and eGFR (HR, 1.35; 95% CI, 1.05-1.73), but was attenuated by adjustment for ACR (HR, 1.15; 95% CI, 0.89-1.48). The top quartile of ACR had a stronger adjusted association with heart failure (HR, 1.96; 95% CI, 1.53-2.51). Limitations Generalizability to other populations is uncertain. Conclusions Higher urine KIM-1 concentrations were associated independently with incident heart failure risk, although the associations of higher ACR were of stronger magnitude.
KW - Index Words
KW - Interleukin 18 (IL-18)
KW - albuminuria
KW - cardiovascular disease (CVD)
KW - chronic kidney disease (CKD)
KW - cystatin C
KW - heart failure
KW - kidney injury molecule 1 (KIM-1)
KW - kidney tubular injury
KW - risk marker
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U2 - 10.1053/j.ajkd.2014.01.432
DO - 10.1053/j.ajkd.2014.01.432
M3 - Article
C2 - 24656453
AN - SCOPUS:84903279324
VL - 64
SP - 49
EP - 56
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
IS - 1
ER -