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Kidney Week

Abstract: TH-PO1110

Elevated Soluble ST2 Levels but Not Galectin-3 Is Associated with Renal Progression and Adverse Clinical Outcomes in Non-Dialysis Patients with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Kim, Ae jin, Gachon University Gil Medical Center, College of Medicine, Gachon University, Incheon, Korea (the Republic of)
  • Chun, Kayeong, Gachon University Gil Medical Center, College of Medicine, Gachon University, Incheon, Korea (the Republic of)
  • Ro, Han, Gachon University Gil Medical Center, College of Medicine, Gachon University, Incheon, Korea (the Republic of)
  • Chang, Jae Hyun, Gachon University Gil Medical Center, College of Medicine, Gachon University, Incheon, Korea (the Republic of)
  • Lee, Hyun Hee, Gachon University Gil Medical Center, College of Medicine, Gachon University, Incheon, Korea (the Republic of)
  • Chung, Wookyung, Gachon University Gil Medical Center, College of Medicine, Gachon University, Incheon, Korea (the Republic of)
  • Jung, Ji Yong, Gachon University Gil Medical Center, College of Medicine, Gachon University, Incheon, Korea (the Republic of)
Background

Soluble ST2 (sST2) and Galectin-3, novel biomarkers of heart failure and cardiovascular stress, predict cardiovascular event and mortality. However, the relationships with renal function and adverse outcomes are less certain. The purpose of this study was to determine whether sST2 and Galectin-3 associated with chronic kidney disease (CKD) progression and adverse clinical outcomes.

Methods

We measured baseline sST2 and Galectin-3 concentrations in CKD patient cohort at our institution included between October 2013 and December 2014. The primary outcome was CKD progression (≥50% reduction in estimated GFR [eGFR] from the baseline or reach to the end-stage renal disease [ESRD]). The secondary outcome was the composite of CKD progression, cardiovascular event, or death. We used Cox proportional hazards model to evaluate associations between sST2 and Galectin-3 level with renal and composite outcomes.

Results

A total of 312 patients were enrolled in this study. At baseline, sST2 was directly associated with serum creatinine (r = 0.492, P < 0.001) and urine protein-to-creatinine ratio (UPCR) (r = 0.309, P < 0.001). Galectin-3 was also directly associated with serum creatinine (r = 0.164, P = 0.004) and UPCR (r = 0.136, P = 0.027). Cox regression analysis showed that baseline sST2 level was independently predicted the CKD progression (hazard ratio [HR] per SD increase in log-transformed sST2 concentration, 16.383; 95% confidence interval [CI], 3.362 – 79.836; P = 0.001) and composite outcome (HR, 5.430; 95% CI, 1.459 – 20.213; P = 0.012) after adjustment for confounding factors. However, baseline Galectin-3 level was associated with CKD progression and composite outcome only in crude analysis, lost its statistical significance after adjustment for confounding variables.

Conclusion

In conclusion, elevated levels of sST2 are significantly associated with renal progression and adverse clinical outcomes in non-dialysis patients with CKD.