Kidney Week

Abstract: FR-OR121

Soluble Urokinase Plasminogen Activation Receptor and Cardiovascular Mortality in Persons Undergoing Coronary Angiography

Session Information

• The Slow Burn: CKD Risk Factors for Incidence and Progression
  November 03, 2017 | Location: Room 395, Morial Convention Center
  Abstract Time: 05:42 PM - 05:54 PM

Category: Chronic Kidney Disease (Non-Dialysis)

• 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

• Sommerer, Claudia, University Hospital of Heidelberg, HEIDELBERG, Germany

Claudia Sommerer, MD



• Kleber, Marcus E, Heidelberg University, Mannheim, Germany

Marcus E Kleber,

• Morath, Christian, University of Heidelberg, Heidelberg, Germany

Christian Morath,

• Reiser, Jochen, Rush University Medical Center, Chicago, Illinois, United States

Jochen Reiser,

• Zeier, Martin G., None, Heidelberg, Germany

Martin G. Zeier,

• März, Winfried, Synlab Services GmbH, Mannheim, Germany

Winfried März,

• Becker, Luis Eduardo, UBAG Nephrologie und Dialyse, Neckarsulm, Germany

Luis Eduardo Becker,

Background

Soluble urokinase plasminogen activation receptor (suPAR) is an emerging biomarker for prediction and progression of kidney disease and cardiovascular outcomes. To further validate the value of suPAR as a cardiorenal biomarker we studied German persons undergoing coronary angiography having a follow-up of ten years.

Methods

suPAR was measured in baseline samples of participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. We estimated overall risk of cardiovascular death by Cox proportional hazards regression according to quartiles of suPAR, including age, sex, use of lipid-lowering drugs, body mass index, diabetes mellitus, hypertension, smoking, LDL cholesterol, HDL cholesterol, triglycerides, as well as eGFR (CKD-EPI), NT-proBNP, IL-6 and CRP as covariates.

Results

A total of 2922 participants (69 % males, mean age 62.7 ± 10.5) having a median GFR of 81ml/min/1.73 m² were included. 393 patients had a GFR<60ml/min /1.73 m². Median suPAR levels 3000 pg/ml (interquartile range, 2250-3980 pg/ml). Using the lowest quartile of suPAR as the reference, crude HRs for cardiovascular mortality were 1.58 (95% CI 1.16-2.16), 1.85 (95% CI 1.37-2.52) and 2.75 (95% CI 2.03-3.71) in the second, third and fourth quartile, respectively. Adjusting for eGFR or inflammation (IL-6 and CRP) did not materially alter this relationship. In a fully adjusted model HRs for cardiovascular death were 1.52 (95% CI 1.11-2.09), 1.56 (95% CI 1.14-2.15), and 1.78 (95% CI 1.28-2.46) in quartiles two to four.

Conclusion

suPAR predicts cardiovascular death over a period of ten years in persons undergoing coronary angiography, independent of kidney function and markers of systemic inflammation. su-PAR has the potential to stratify the risk in patients with cardiovascular disease and kidney disease. su-PAR could be a useful and additional biomarker in cardiovascular and renal medicine.

Funding

• Private Foundation Support