Abstract 1642: Markers of Inflammation and the Risk of Developing Chronic Kidney Disease: Population-based Cohort Study
Background: Inflammatory processes are implicated in the development of diabetes and hypertension, which are risk factors of chronic kidney disease (CKD). In animal models, inflammatory processes have been shown to play an important role in kidney disease development. However, in humans, the independent relation between markers of inflammation and the risk of developing CKD is not clear.
Objective: To examine the relationship of high sensitivity C-reactive protein (CRP) and tumor necrosis factor-alpha receptor2 (TNF-αR2) levels to CKD.
Design: Population-based cohort in Beaver Dam, Wisconsin (aged 44 – 85 years, 49% women) with 15 year follow-up data.
Setting: General community
Participants: We performed 2 set of analyses:
cross-sectional analysis among 4880 individuals with prevalent CKD (n=623) as the outcome-of-interest and
longitudinal analysis among 1889 CKD-free individuals at baseline with 15-year incident CKD as the outcome-of-interest (n=675).
Multivariable logistic regression models were used to calculate odds ratio (OR) and 95 percent confidence intervals (CI).
Main Outcome Measure: CKD, defined as estimated GFR<60 mL/min/1.73m2.
Results: In the cross-sectional analysis, we found that both CRP (OR [95%CI] comparing highest vs. lowest tertile: 1.48 [1.17–1.88]; p-trend=0.0007) and TNF-αR2 levels (OR [95%CI] comparing highest vs. lowest tertile: 3.51 [2.19 –5.61]; p-trend<0.0001) were positively associated with prevalent CKD. However, in the longitudinal analysis examining risk of developing CKD, only TNF-αR2 levels (OR [95%CI] comparing highest vs. lowest tertile: 2.22 [1.51–3.26]; p-trend<0.0001), not CRP levels (OR [95%CI] highest vs. lowest tertile: 1.11 [0.87–1.41]; p-trend=0.40), were associated with 15-year incident CKD.
Conclusions: Results from this study support the hypothesis of an association between elevated serum TNF-αR2 levels and the risk of developing CKD, suggesting a role for inflammatory mechanisms related TNF-α in the etiology of CKD. Our results also suggest that elevated serum CRP may be a marker of heightened inflammatory processes that are activated secondary to kidney disease.