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血清生长分化因子 15 水平在肾脏疾病患者中的意义。

Implication of serum growth differentiation factor-15 level in patients with renal diseases.

机构信息

The Second Department of Internal Medicine, Toyama University, 2630 Sugitani, Toyama, 930-0194, Japan.

出版信息

Int Urol Nephrol. 2023 Nov;55(11):2935-2941. doi: 10.1007/s11255-023-03580-7. Epub 2023 Apr 3.

Abstract

BACKGROUND

The synthesis of growth differentiation factor-15 (GDF-15) is induced by inflammation, hypoxia, and oxidative stress and is receiving great interest as a predictive biomarker for cardiovascular disease. However, its detailed impact on patients with renal disease remains uncertain.

METHODS

Patients who underwent renal biopsy for evaluation of renal disease between 2012 and 2017 in our institute were prospectively included. Serum GDF-15 levels were measured and its association with baseline characteristics and its impact on the 3-year composites of renal prognosis (composites of > 1.5 folds of serum creatinine and renal replacement therapy) were investigated.

RESULTS

A total of 110 patients (64 [42, 73] years old, 61 men) were included. The median serum GDF-15 level at baseline was 1885 (998, 3496) pg/mL. A higher serum GDF-15 level was associated with comorbidities including diabetes mellitus, anemia, renal impairment, and pathologic features including crescent formation, hyaline degeneration, and interstitial fibrosis (p < 0.05 for all). Serum GDF-15 level was a significant predictor of 3-year composite renal outcomes with an odds ratio per 100 pg/mL of 1.072 (95% confidence interval 1.001-1.103, p = 0.036) after adjustment for potential confounders.

CONCLUSIONS

Serum GDF-15 levels were associated with several renal pathological features and renal prognosis in patients with renal diseases.

摘要

背景

生长分化因子 15(GDF-15)的合成受炎症、缺氧和氧化应激诱导,作为心血管疾病的预测生物标志物受到广泛关注。然而,其对肾病患者的详细影响尚不确定。

方法

本研究前瞻性纳入 2012 年至 2017 年在我院接受肾活检评估肾病的患者。检测血清 GDF-15 水平,探讨其与基线特征的关系及其对 3 年肾脏预后综合指标(血清肌酐升高 1.5 倍以上和肾脏替代治疗)的影响。

结果

共纳入 110 例患者(64[42,73]岁,61 名男性)。基线时血清 GDF-15 中位数为 1885(998,3496)pg/ml。较高的血清 GDF-15 水平与合并症(包括糖尿病、贫血、肾功能不全)和病理特征(包括新月体形成、玻璃样变性、间质纤维化)有关(所有 P 值均<0.05)。校正潜在混杂因素后,血清 GDF-15 水平每增加 100 pg/ml,3 年复合肾脏结局的优势比为 1.072(95%置信区间 1.001-1.103,P=0.036)。

结论

血清 GDF-15 水平与肾病患者的多种肾脏病理特征和肾脏预后相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc89/10069349/657242d46eae/11255_2023_3580_Fig1_HTML.jpg

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