Bourgonje Arno R, Bourgonje Martin F, la Bastide-van Gemert Sacha, Nilsen Tom, Hidden Clara, Gansevoort Ron T, Mulder Douwe J, Hillebrands Jan-Luuk, Bakker Stephan J L, Dullaart Robin P F, van Goor Harry, Abdulle Amaal E
Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Kidney Int Rep. 2024 Feb 16;9(5):1265-1275. doi: 10.1016/j.ekir.2024.02.1392. eCollection 2024 May.
INTRODUCTION: Systemic inflammation has been associated with chronic kidney disease (CKD). In this study, we aimed to investigate a potential association between the plasma biomarker of inflammation calprotectin and new-onset CKD in a population-based cohort study. METHODS: Individuals without CKD at baseline ( = 4662) who participated in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) prospective population-based cohort study in the Netherlands were included. Baseline plasma calprotectin levels were assessed in samples that had been stored at -80 °C. Occurrence of new-onset CKD was defined as a composite outcome of an estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m, urinary albumin excretion (UAE) >30 mg/24h, or both. RESULTS: Baseline median (interquartile range) plasma calprotectin levels were 0.49 (0.35-0.68) mg/l and baseline median eGFR was 95.9 (interquartile range: 85.0-105.7) ml/min per 1.73 m. After median follow-up of 8.3 (7.8-8.9) years, 467 participants developed new-onset CKD. Baseline plasma calprotectin levels were significantly associated with an increased risk of new-onset CKD (hazard ratio [HR] per doubling 1.28 [95% confidence interval, CI: 1.14-1.44], < 0.001), independent of potentially confounding factors (HR 1.14 [95% CI: 1.01-1.29], = 0.034), except for baseline high-sensitive C-reactive protein (hs-CRP) (HR 1.05 [0.91-1.21], = 0.494). In secondary analyses, the association between plasma calprotectin and occurrence of UAE >30 mg/24h remained significant (HR 1.17 [1.02-1.34], = 0.027), but not significantly so for the incidence of eGFR <60 ml/min per 1.73 m as individual outcome (HR 1.15 [0.92-1.43], = 0.218). CONCLUSION: Higher plasma calprotectin levels are associated with an increased risk of developing CKD in the general population. This association is mitigated after adjustment for hs-CRP, and more pronounced with new-onset CKD defined by UAE.
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