| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2003;107:87.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
From the Departments of Medicine, Epidemiology, and Biostatistics, University of California, San Francisco, and the Veterans Affairs Medical Center, San Francisco (M.G.S.); Renal-Electrolyte Division, University of Pittsburgh School of Medicine, and the Renal Section, VA Pittsburgh Healthcare System (L.F.F.); Departments of Medicine (B.M.P.), Epidemiology (B.M.P., C.C.), and Health Services (B.M.P.), University of Washington, Seattle; the Section of Nephrology (A.J.B.) and the Department of Public Health Sciences (C.D.F.), Wake Forest/Bowman Gray School of Medicine, Winston-Salem, NC; the Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, Md (T.A.M.); and the Departments of Pathology and Biochemistry, the University of Vermont College of Medicine, Burlington, Vt (R.P.T.).
Correspondence to Michael G. Shlipak, MD, MPH, VA Medical Center (111A1), 4150 Clement St, San Francisco, CA 94121. E-mail shlip{at}itsa.ucsf.edu
Background Renal insufficiency has been associated with cardiovascular disease events and mortality in several prospective studies, but the mechanisms for the elevated risk are not clear. Little is known about the association of renal insufficiency with inflammatory and procoagulant markers, which are potential mediators for the cardiovascular risk of kidney disease.
Methods and Results The cross-sectional association of renal insufficiency with 8 inflammatory and procoagulant factors was evaluated using baseline data from the Cardiovascular Health Study, a population-based cohort study of 5888 subjects aged
65 years. C-reactive protein, fibrinogen, factor VIIc, and factor VIIIc levels were measured in nearly all participants; interleukin-6, intercellular adhesion molecule-1, plasmin-antiplasmin complex, and D-dimer levels were measured in nearly half of participants. Renal insufficiency was defined as a serum creatinine level
1.3 mg/dL in women and
1.5 mg/dL in men. Multivariate linear regression was used to compare adjusted mean levels of each biomarker in persons with and without renal insufficiency after adjustment for other baseline characteristics. Renal insufficiency was present in 647 (11%) of Cardiovascular Health Study participants. After adjustment for baseline differences, levels of C-reactive protein, fibrinogen, interleukin-6, factor VIIc, factor VIIIc, plasmin-antiplasmin complex, and D-dimer were significantly greater among persons with renal insufficiency (P<0.001). In participants with clinical, subclinical, and no cardiovascular disease at baseline, the positive associations of renal insufficiency with these inflammatory and procoagulant markers were similar.
Conclusion Renal insufficiency was independently associated with elevations in inflammatory and procoagulant biomarkers. These pathways may be important mediators leading to the increased cardiovascular risk of persons with kidney disease.
Key Words: inflammation coagulation kidney coronary disease
This article has been cited by other articles:
![]() |
Y. P. Liew, J. R. Bartholomew, S. Demirjian, J. Michaels, and M. J. Schreiber Jr. Combined Effect of Chronic Kidney Disease and Peripheral Arterial Disease on All-Cause Mortality in a High-Risk Population Clin. J. Am. Soc. Nephrol., July 1, 2008; 3(4): 1084 - 1089. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Yende, G. D'Angelo, J. A. Kellum, L. Weissfeld, J. Fine, R. D. Welch, L. Kong, M. Carter, D. C. Angus, and for the GenIMS Investigators Inflammatory Markers at Hospital Discharge Predict Subsequent Mortality after Pneumonia and Sepsis Am. J. Respir. Crit. Care Med., June 1, 2008; 177(11): 1242 - 1247. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. D. Schocken, E. J. Benjamin, G. C. Fonarow, H. M. Krumholz, D. Levy, G. A. Mensah, J. Narula, E. S. Shor, J. B. Young, and Y. Hong Prevention of Heart Failure: A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group Circulation, May 13, 2008; 117(19): 2544 - 2565. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Mittalhenkle, C. O. Stehman-Breen, M. G. Shlipak, L. F. Fried, R. Katz, B. A. Young, S. Seliger, D. Gillen, A. B. Newman, B. M. Psaty, et al. Cardiovascular Risk Factors and Incident Acute Renal Failure in Older Adults: The Cardiovascular Health Study Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(2): 450 - 456. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. J. Sarnak, R. Katz, L. F. Fried, D. Siscovick, B. Kestenbaum, S. Seliger, D. Rifkin, R. Tracy, A. B. Newman, M. G. Shlipak, et al. Cystatin C and Aging Success Arch Intern Med, January 28, 2008; 168(2): 147 - 153. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Chen, E. J. O'Reilly, M. A. Schwarzschild, and A. Ascherio Peripheral Inflammatory Biomarkers and Risk of Parkinson's Disease Am. J. Epidemiol., January 1, 2008; 167(1): 90 - 95. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Khatri, C. B. Wright, T. L. Nickolas, M. Yoshita, M. C. Paik, G. Kranwinkel, R. L. Sacco, and C. DeCarli Chronic Kidney Disease Is Associated With White Matter Hyperintensity Volume: The Northern Manhattan Study (NOMAS) Stroke, December 1, 2007; 38(12): 3121 - 3126. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. B. Chonchol, V. Aboyans, P. Lacroix, G. Smits, T. Berl, and M. Laskar Long-term outcomes after coronary artery bypass grafting: Preoperative kidney function is prognostic J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 683 - 689. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. G. Glynn, D. Reddan, J. Newell, J. Hinde, B. Buckley, and A. W. Murphy Chronic kidney disease and mortality and morbidity among patients with established cardiovascular disease: a West of Ireland community-based cohort study Nephrol. Dial. Transplant., September 1, 2007; 22(9): 2586 - 2594. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Tong, J. J. Carrero, A. R. Qureshi, B. Anderstam, O. Heimburger, P. Barany, J. Axelsson, A. Alvestrand, P. Stenvinkel, B. Lindholm, et al. Plasma Pentraxin 3 in Patients with Chronic Kidney Disease: Associations with Renal Function, Protein-Energy Wasting, Cardiovascular Disease, and Mortality Clin. J. Am. Soc. Nephrol., September 1, 2007; 2(5): 889 - 897. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. M. Hailpern, M. L. Melamed, H. W. Cohen, and T. H. Hostetter Moderate Chronic Kidney Disease and Cognitive Function in Adults 20 to 59 Years of Age: Third National Health and Nutrition Examination Survey (NHANES III) J. Am. Soc. Nephrol., July 1, 2007; 18(7): 2205 - 2213. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. E. Ensrud, L.-Y. Lui, B. C. Taylor, A. Ishani, M. G. Shlipak, K. L. Stone, J. A. Cauley, S. A. Jamal, D. M. Antoniucci, S. R. Cummings, et al. Renal Function and Risk of Hip and Vertebral Fractures in Older Women Arch Intern Med, January 22, 2007; 167(2): 133 - 139. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. C. Odden, G. M. Chertow, L. F. Fried, A. B. Newman, S. Connelly, S. Angleman, T. B. Harris, E. M. Simonsick, M. G. Shlipak, and for the HABC Study Cystatin C and Measures of Physical Function in Elderly Adults: The Health, Aging, and Body Composition (HABC) Study Am. J. Epidemiol., December 15, 2006; 164(12): 1180 - 1189. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. G. Wannamethee, A. G. Shaper, G. D.O. Lowe, L. Lennon, A. Rumley, and P. H. Whincup Renal function and cardiovascular mortality in elderly men: the role of inflammatory, procoagulant, and endothelial biomarkers Eur. Heart J., December 2, 2006; 27(24): 2975 - 2981. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Goncalves, R. Pecoits-Filho, S. Perreto, S. H. Barberato, A. E. M. Stinghen, E. G. A. Lima, R. Fuerbringer, S. M. Sauthier, and M. C. Riella Associations between renal function, volume status and endotoxaemia in chronic kidney disease patients Nephrol. Dial. Transplant., October 1, 2006; 21(10): 2788 - 2794. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. G. Coca, H. M. Krumholz, A. X. Garg, and C. R. Parikh Underrepresentation of renal disease in randomized controlled trials of cardiovascular disease. JAMA, September 20, 2006; 296(11): 1377 - 1384. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. de Rekeneire, R. Peila, J. Ding, L. H. Colbert, M. Visser, R. I. Shorr, S. B. Kritchevsky, L. H. Kuller, E. S. Strotmeyer, A. V. Schwartz, et al. Diabetes, Hyperglycemia, and Inflammation in Older Individuals: The Health, Aging and Body Composition study Diabetes Care, August 1, 2006; 29(8): 1902 - 1908. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. Amann, C. Wanner, and E. Ritz Cross-Talk between the Kidney and the Cardiovascular System J. Am. Soc. Nephrol., August 1, 2006; 17(8): 2112 - 2119. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Koren-Morag, U. Goldbourt, and D. Tanne Renal dysfunction and risk of ischemic stroke or TIA in patients with cardiovascular disease. Neurology, July 25, 2006; 67(2): 224 - 228. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. F. Fried, M. G. Shlipak, C. Stehman-Breen, A. Mittalhenkle, S. Seliger, M. Sarnak, J. Robbins, D. Siscovick, T. B. Harris, A. B. Newman, et al. Kidney function predicts the rate of bone loss in older individuals: the cardiovascular health study. J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2006; 61(7): 743 - 748. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Dhaun, J. Goddard, and DavidJ. Webb The Endothelin System and Its Antagonism in Chronic Kidney Disease J. Am. Soc. Nephrol., April 1, 2006; 17(4): 943 - 955. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Rashidi, M. Rahman, M. Tonelli, C. Isles, T. Craven, C. Furberg, A. Tonkin, M. A. Pfeffer, J. Shepherd, S. M. Cobbe, et al. Letter Regarding Article by Tonelli et al, "Effect of Pravastatin on Rate of Kidney Function Loss in People With or at Risk for Coronary Disease" * Response Circulation, January 31, 2006; 113(4): e59 - e60. [Full Text] [PDF] |
||||
![]() |
R. W. Schrier Role of Diminished Renal Function in Cardiovascular Mortality: Marker or Pathogenetic Factor? J. Am. Coll. Cardiol., January 3, 2006; 47(1): 1 - 8. [Abstract] [Full Text] |
||||
![]() |
M. G. Shlipak, C. L. W. Fyr, G. M. Chertow, T. B. Harris, S. B. Kritchevsky, F. A. Tylavsky, S. Satterfield, S. R. Cummings, A. B. Newman, and L. F. Fried Cystatin C and Mortality Risk in the Elderly: The Health, Aging, and Body Composition Study J. Am. Soc. Nephrol., January 1, 2006; 17(1): 254 - 261. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. A. Khan, I. Ma, C. R. Thompson, K. Humphries, D. N. Salem, M. J. Sarnak, and A. Levin Kidney Function and Mortality among Patients with Left Ventricular Systolic Dysfunction J. Am. Soc. Nephrol., January 1, 2006; 17(1): 244 - 253. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. F. Fried, R. Katz, M. J. Sarnak, M. G. Shlipak, P. H.M. Chaves, N. S. Jenny, C. Stehman-Breen, D. Gillen, A. J. Bleyer, C. Hirsch, et al. Kidney Function as a Predictor of Noncardiovascular Mortality J. Am. Soc. Nephrol., December 1, 2005; 16(12): 3728 - 3735. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Nishimura, T. Hashimoto, H. Kobayashi, T. Fukuda, K. Okino, N. Yamamoto, C. Mashida, K. Kawagoe, H. Fujita, N. Inoue, et al. Close association of Chlamydia pneumoniae IgA seropositivity by ELISA with the presence of coronary artery stenosis in haemodialysis patients Nephrol. Dial. Transplant., September 1, 2005; 20(9): 1944 - 1950. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. S. Strotmeyer, J. A. Cauley, A. V. Schwartz, M. C. Nevitt, H. E. Resnick, D. C. Bauer, F. A. Tylavsky, N. de Rekeneire, T. B. Harris, and A. B. Newman Nontraumatic Fracture Risk With Diabetes Mellitus and Impaired Fasting Glucose in Older White and Black Adults: The Health, Aging, and Body Composition Study Arch Intern Med, July 25, 2005; 165(14): 1612 - 1617. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Kurella, G. M. Chertow, L. F. Fried, S. R. Cummings, T. Harris, E. Simonsick, S. Satterfield, H. Ayonayon, and K. Yaffe Chronic Kidney Disease and Cognitive Impairment in the Elderly: The Health, Aging, and Body Composition Study J. Am. Soc. Nephrol., July 1, 2005; 16(7): 2127 - 2133. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Vanholder, Z. Massy, A. Argiles, G. Spasovski, F. Verbeke, N. Lameire, and for the European Uremic Toxin Work Group (EUTox) Chronic kidney disease as cause of cardiovascular morbidity and mortality Nephrol. Dial. Transplant., June 1, 2005; 20(6): 1048 - 1056. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Di Napoli, M. Schwaninger, R. Cappelli, E. Ceccarelli, G. Di Gianfilippo, C. Donati, H. C.A. Emsley, S. Forconi, S. J. Hopkins, L. Masotti, et al. Evaluation of C-Reactive Protein Measurement for Assessing the Risk and Prognosis in Ischemic Stroke: A Statement for Health Care Professionals From the CRP Pooling Project Members Stroke, June 1, 2005; 36(6): 1316 - 1329. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. J. Sarnak, R. Katz, C. O. Stehman-Breen, L. F. Fried, N. S. Jenny, B. M. Psaty, A. B. Newman, D. Siscovick, M. G. Shlipak, and and the Cardiovascular Health Study* Cystatin C Concentration as a Risk Factor for Heart Failure in Older Adults Ann Intern Med, April 5, 2005; 142(7): 497 - 505. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Saemann, T Weichhart, M Zeyda, G Staffler, M Schunn, K. Stuhlmeier, Y Sobanov, T. Stulnig, S Akira, A von Gabain, et al. Immunoregulation in Urinary Tract Inflammation--A Role of Tamm-Horsfall Glycoprotein: Tamm-Horsfall Glycoprotein Links Innate Immune Cell Activation with Adaptive Immunity via a Toll-Like Receptor-4-Dependent Mechanism. J Clin Invest 115: 468-475, 2005 J. Am. Soc. Nephrol., April 1, 2005; 16(4): 829 - 836. [Full Text] [PDF] |
||||
![]() |
E. M. Stuveling, S. J. L. Bakker, H. L. Hillege, P. E. de Jong, R. O. B. Gans, and D. de Zeeuw Biochemical risk markers: a novel area for better prediction of renal risk? Nephrol. Dial. Transplant., March 1, 2005; 20(3): 497 - 508. [Full Text] [PDF] |
||||
![]() |
W. Koenig, D. Twardella, H. Brenner, and D. Rothenbacher Plasma Concentrations of Cystatin C in Patients with Coronary Heart Disease and Risk for Secondary Cardiovascular Events: More than Simply a Marker of Glomerular Filtration Rate Clin. Chem., February 1, 2005; 51(2): 321 - 327. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Fried, C. Solomon, M. Shlipak, S. Seliger, C. Stehman-Breen, A. J. Bleyer, P. Chaves, C. Furberg, L. Kuller, and A. Newman Inflammatory and Prothrombotic Markers and the Progression of Renal Disease in Elderly Individuals J. Am. Soc. Nephrol., December 1, 2004; 15(12): 3184 - 3191. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. C. Odden, M. A. Whooley, and M. G. Shlipak Association of Chronic Kidney Disease and Anemia with Physical Capacity: The Heart and Soul Study J. Am. Soc. Nephrol., November 1, 2004; 15(11): 2908 - 2915. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Gupta, Y. Birnbaum, and B. F. Uretsky The renal patient with coronary artery disease: Current concepts and dilemmas J. Am. Coll. Cardiol., October 6, 2004; 44(7): 1343 - 1353. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. S. Go, G. M. Chertow, D. Fan, C. E. McCulloch, and C.-y. Hsu Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and Hospitalization N. Engl. J. Med., September 23, 2004; 351(13): 1296 - 1305. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. S. Fox, Q. Yang, L. A. Cupples, C.-Y. Guo, M. G. Larson, E. P. Leip, P. W.F. Wilson, and D. Levy Genomewide Linkage Analysis to Serum Creatinine, GFR, and Creatinine Clearance in a Community-Based Population: The Framingham Heart Study J. Am. Soc. Nephrol., September 1, 2004; 15(9): 2457 - 2461. [Abstract] [Full Text] [PDF] |
||||
![]() |
C Mueller, F-J Neumann, A P Perruchoud, and H J Buettner Renal function and long term mortality after unstable angina/non-ST segment elevation myocardial infarction treated very early and predominantly with percutaneous coronary intervention Heart, August 1, 2004; 90(8): 902 - 907. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Y.-M. Wang, M. Wang, J. Woo, C. W.-K. Lam, S.-F. Lui, P. K.-T. Li, and J. E. Sanderson Inflammation, Residual Kidney Function, and Cardiac Hypertrophy Are Interrelated and Combine Adversely to Enhance Mortality and Cardiovascular Death Risk of Peritoneal Dialysis Patients J. Am. Soc. Nephrol., August 1, 2004; 15(8): 2186 - 2194. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. G. Shlipak, G. L. Smith, S. S. Rathore, B. M. Massie, and H. M. Krumholz Renal Function, Digoxin Therapy, and Heart Failure Outcomes: Evidence from the Digoxin Intervention Group Trial J. Am. Soc. Nephrol., August 1, 2004; 15(8): 2195 - 2203. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. L. Knight, E. B. Rimm, J. K. Pai, K. M. Rexrode, C. C. Cannuscio, J. E. Manson, M. J. Stampfer, and G. C. Curhan Kidney Dysfunction, Inflammation, and Coronary Events: A Prospective Study J. Am. Soc. Nephrol., July 1, 2004; 15(7): 1897 - 1903. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. Amann, M.-L. Gross, and E. Ritz Pathophysiology Underlying Accelerated Atherogenesis in Renal Disease: Closing in on the Target J. Am. Soc. Nephrol., June 1, 2004; 15(6): 1664 - 1666. [Full Text] [PDF] |
||||
![]() |
A. M. O'Hare, E. Vittinghoff, J. Hsia, and M. G. Shlipak Renal Insufficiency and the Risk of Lower Extremity Peripheral Arterial Disease: Results from the Heart and Estrogen/Progestin Replacement Study (HERS) J. Am. Soc. Nephrol., April 1, 2004; 15(4): 1046 - 1051. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. M. Chertow A 43-Year-Old Woman With Chronic Renal Insufficiency JAMA, March 10, 2004; 291(10): 1252 - 1259. [Full Text] [PDF] |
||||
![]() |
G. A. Kaysen and J. P. Eiserich The Role of Oxidative Stress-Altered Lipoprotein Structure and Function and Microinflammation on Cardiovascular Risk in Patients with Minor Renal Dysfunction J. Am. Soc. Nephrol., March 1, 2004; 15(3): 538 - 548. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Segura, C. Campo, C. Roldan, H. Christiansen, L. Vigil, R. Garcia-Robles, J. L. Rodicio, and L. M. Ruilope Hypertensive Renal Damage in Metabolic Syndrome Is Associated with Glucose Metabolism Disturbances J. Am. Soc. Nephrol., January 1, 2004; 15(90010): S37 - 42. [Abstract] [Full Text] |
||||
![]() |
J. H. Ix, M. G. Shlipak, H. H. Liu, N. B. Schiller, and M. A. Whooley Association between Renal Insufficiency and Inducible Ischemia in Patients with Coronary Artery Disease: The Heart and Soul Study J. Am. Soc. Nephrol., December 1, 2003; 14(12): 3233 - 3238. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. J. Sarnak, A. S. Levey, A. C. Schoolwerth, J. Coresh, B. Culleton, L. L. Hamm, P. A. McCullough, B. L. Kasiske, E. Kelepouris, M. J. Klag, et al. Kidney Disease as a Risk Factor for Development of Cardiovascular Disease: A Statement From the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention Hypertension, November 1, 2003; 42(5): 1050 - 1065. [Full Text] [PDF] |
||||
![]() |
M. J. Sarnak, A. S. Levey, A. C. Schoolwerth, J. Coresh, B. Culleton, L. L. Hamm, P. A. McCullough, B. L. Kasiske, E. Kelepouris, M. J. Klag, et al. Kidney Disease as a Risk Factor for Development of Cardiovascular Disease: A Statement From the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention Circulation, October 28, 2003; 108(17): 2154 - 2169. [Full Text] [PDF] |
||||
![]() |
B. Hocher, R. Ziebig, C. Altermann, R. Krause, G. Asmus, C.-M. Richter, T. Slowinski, P. Sinha, and H.-H. Neumayer Different Impact of Biomarkers as Mortality Predictors among Diabetic and Nondiabetic Patients Undergoing Hemodialysis J. Am. Soc. Nephrol., September 1, 2003; 14(9): 2329 - 2337. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Stenvinkel, R. Pecoits-Filho, and B. Lindholm Coronary Artery Disease in End-Stage Renal Disea |