Kidney Week

Abstract: TH-PO465

ADAM17 as a Predictor of CV Events in CKD Patients

Session Information

• Hypertension and CVD: Epidemiology, Risk Factors, Prevention
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

• Palau, Vanesa, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain

Vanesa Palau,

• Riera, Marta, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain

Marta Riera,

• Benito, David, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain

David Benito,

• Valdivielso, Jose M., IRB LLEIDA, LLEIDA, Spain

Jose M. Valdivielso,

• Betriu, Angels, IRB LLEIDA, LLEIDA, Spain

Angels Betriu,

• Fernandez, Elvira, IRB LLEIDA, LLEIDA, Spain

Elvira Fernandez,

• Pascual, Julio, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain

Julio Pascual,

• Soler, Maria Jose, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain

Maria Jose Soler,

Background

Previous studies have demonstrated a positive correlation between ADAM17 and TNFα in cardiovascular (CV) disease. Increased expression of TNFα and ADAM17 has important implications in advanced cardiac dysfunction. We studied the relationship between baseline circulating ADAM17 activity, cardiovascular events and mortality in CKD patients from the NEFRONA study after 48 months of follow-up.

Methods

2,570 patients without history of previous CV disease from the observational and multicenter NEFRONA study were divided into three groups: non-dialysis CKD stage 3-5 patients (CKD3-5, n=1,463), hemodialysis or peritoneal dialysis patients (CKD5D, n=538) and control patients (CONT, n=569).

Baseline circulating ADAM17 activity was analyzed using a fluorimetric assay in plasma samples. Survival was analyzed by Kaplan-Meier curves for the following events: CV event, CV mortality, non-CV mortality and all mortality causes according to ADAM17 activity, diabetes, age, smoking and dialysis requirement. Cox regression analyses were used to identify risk factors for these events.

Results

Circulating ADAM17 activity was higher in patients with CV events and in patients with CV mortality, non-CV mortality and all-cause mortality (p<0.05). In the unadjusted Cox model, circulating ADAM17 activity was a risk factor for CV events, CV mortality and all-cause mortality in CKD patients. However, circulating ADAM17 was not a risk factor for non-CV mortality.

In the multivariate Cox regression model, circulating ADAM17 activity, older age, male sex, diabetes and dialysis were identified as independent risk factors for CV events.

Conclusion

Higher levels of circulating ADAM17 activity correlated with a worst survival rate in patients with CV events, CV death and all mortality causes. Circulating ADAM17 activity could be an independent predictor for CV events in CKD patients without previous history of CV disease.

Funding

• Government Support - Non-U.S.