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Kidney Week

Abstract: PO0431

Soluble Urokinase Plasminogen Activation Receptor and Major Adverse Cardiac Event Morbidity in CKD Patients in the German Chronic Kidney Disease (GCKD) Cohort

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Sommerer, Claudia, Department of Nephrology, University Hospital Heidelberg, Heidelberg, Germany
  • Müller-Krebs, Sandra, Department of Nephrology, University Hospital Heidelberg, Heidelberg, Germany
  • Nadal, Jennifer, Department of Medical Biometry, Informatics, and Epidemiology (IMBIE), University Hospital of Bonn, Bonn, Germany
  • Schmid, Matthias, Department of Medical Biometry, Informatics, and Epidemiology (IMBIE), University Hospital of Bonn, Bonn, Germany
  • Eckardt, Kai-Uwe, Department of Nephrology, Charité, University Medicine Berlin, Berlin, Germany
  • Reiser, Jochen, Department of Medicine, Rush University Medical Center, Chicago, Illinois, United States
  • Zeier, Martin G., Department of Nephrology, University Hospital Heidelberg, Heidelberg, Germany
Background

Soluble urokinase plasminogen activation receptor (suPAR) is supposed as risk factor for both chronic kidney disease (CKD) and biomarker for major adverse cardiac events (MACE) disease. A long-term longitudinal analysis in a large cohort of patients suffering from both diseases simultaneously, CKD and cardiovascular (CV) disease including MACE criteria, to analyze suPAR as a predictive biomarker has not been performed, yet.

Methods

SuPAR was studied in the GCKD Study Group with a follow-up time of 4 years. Association of suPAR with CKD (estimated glomerular filtration rate, eGFR) and overall risk of all-cause death, CV death, and MACE (three-point MACE, MACE3; four-point MACE, MACE4) was estimated by Cox proportional hazards regression according to quintiles of suPAR.

Results

Altogether, 4994 participants were enrolled (60.1 ± 12.0 years; eGFR of 49.4 ±18.3 mL/min/1.73m2). Median suPAR concentration was 1771 pg/mL (25th-75th percentile, 1447-2254 pg/mL). Hazard ratio for CV mortality was 1.58 (95%CI 0.62-4.00) in the second, 2.15 (95%CI 0.87-5.26) in the third, 3.48 (95%CI 1.53-7.93) in the fourth, and 5.30 (95%CI 2.34-12.0) in the fifth quintile. If additionally adjusted for eGFR, UACR, NT-proBNP, hsCRP results were confirmed.

Conclusion

In the GCKD study cohort suPAR predicts all-cause death, cardiovascular death, and MACE independent of NT-proBNP, renal function and of markers of systemic inflammation.