Kidney Week

Abstract: SA-OR039

Two-Year Change in Galectin 3 and MMP-2 and Risk of ESRD: The Chronic Renal Insufficiency Cohort (CRIC) Study

Session Information

• Biomarkers in CKD
  November 09, 2019 | Location: 152, Walter E. Washington Convention Center
  Abstract Time: 04:42 PM - 04:54 PM

Category: CKD (Non-Dialysis)

• 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Anderson, Amanda Hyre, Tulane University, New Orleans, Louisiana, United States

Amanda Hyre Anderson, PhD, MPH



Dr. Anderson is an Associate Professor of Epidemiology at the Tulane School of Public Health and Tropical Medicine, and Associate Director of the Tulane University Translational Science Institute. Her major research interests address the epidemiology of kidney diseases, with an emphasis on the causes and consequences of the excessive morbidity and mortality experienced by patients with chronic kidney disease (CKD). She has a particular focus on factors associated with CKD progression including fibrosis measures and the gut microbiome, prediction of kidney function decline over time, and the insufficiently characterized burden of co-morbidities and outcomes associated with CKD. Dr. Anderson is the principal investigator of two NIH/NIDDK R01 studies to investigate blood and urine fibrosis measures as predictors of CKD progression and cardiovascular disease in the setting of CKD, and to examine associations between the gut microbiome, plasma and fecal metabolomes, and CKD progression. She also has over 10 years of experience providing scientific and operational leadership to Scientific and Data Coordinating Centers of large, multi-center studies examining risk factors for cardiovascular disease and progression of kidney disease among adults with CKD.

• Orlandi, Paula Ferreira, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Paula Ferreira Orlandi,

• Yang, Wei, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Wei Yang,

• Baudier, Robin Leigh, Tulane University, New Orleans, Louisiana, United States

Robin Leigh Baudier,

• Susztak, Katalin, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Katalin Susztak,

• Srivastava, Anand, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Anand Srivastava,

• Ricardo, Ana C., University of Illinois at Chicago, Chicago, Illinois, United States

Ana C. Ricardo,

• Dobre, Mirela A., Case Western Reserve University, Cleveland, Ohio, United States

Mirela A. Dobre,

• Deo, Rajat, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Rajat Deo,

• Chen, Jing, Tulane School of Medicine, New Orleans, Louisiana, United States

Jing Chen,

• He, Jiang, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States

Jiang He,

• Shafi, Tariq, University of Mississippi Medical Center, Jackson, Mississippi, United States

Tariq Shafi,

• Chen, Hsiang-Yu, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States

Hsiang-Yu Chen,

• Xie, Dawei, University of Pennsylvania School of Medicine Center for Clinical Epidemiology and Biostatistics, Philadelphia, Pennsylvania, United States

Dawei Xie,

• Bansal, Nisha, Kidney Research Institute, Seattle, Washington, United States

Nisha Bansal,

• Feldman, Harold I., University of Pennsylvania, Philadelphia, Pennsylvania, United States

Harold I. Feldman,

Background

Galectin-3 and matrix metalloproteinase-2 (MMP-2) have both been associated with kidney fibrosis, however, the relationship of these markers with chronic kidney disease (CKD) progression remains unclear.

Methods

A case-cohort study including a randomly selected sample of 1300 CRIC participants was conducted to characterize the association of two-year change in plasma galectin-3 and MMP-2 with subsequent development of end-stage renal disease (ESRD; N=542). Weighted Cox proportional hazards regression models used data from up to 8 years of follow-up, adjusted for sociodemographic, clinical and biochemical factors including eGFR and proteinuria in addition to galectin-3 or MMP-2 values from baseline.

Results

Two-year change in galectin-3 ranged from -51 to + 56 ng/mL with an overall mean change of 4.3 ng/mL, while change in MMP-2 ranged from -455 to +654 ng/mL (mean change: 25.4 ng/mL). Restricted cubic splines demonstrate non-linear associations for both markers (Figure). Increases in galectin-3 over two years did not appear to increase ESRD risk, but decreases may trend toward reduced risk of ESRD. The hazard ratio for MMP-2 reductions of 400 ng/mL was 0.2 (95% CI: 0.1-0.5).

Conclusion

Decreases in MMP-2 over two years are strongly and independently associated with marked reduction in the risk for ESRD among patients with established CKD. This pathway should be studied further to investigate possible interventions to reduce CKD progression risk.

Funding

• NIDDK Support