Abstract
BackgroundThere is evidence that chronic inflammation is associated with the progression/development of chronic renal failure; however, relations in subjects with preserved renal function remain insufficiently understood.ObjectiveTo examine the association of inflammation with the development of renal failure in a cohort of the elderly general population.MethodsAfter excluding subjects with reduced estimated glomerular filtration rate (eGFR<60 mL/min/1.73 m2) and missing data, the cohort incorporated 785 men and 659 women (aged 45–83 years). Follow-up was performed four years after baseline. Covariate adjusted linear and logistic regression models were used to assess the association of plasma/serum concentrations of soluble tumour necrosis factor receptor 1 (sTNF-R1), C-reactive protein (CRP), and interleukin 6 (IL-6) with change in eGFR/creatinine. The areas under the curve (AUCs) from receiver operating characteristics (ROCs) were estimated.ResultsIn adjusted models sTNF-R1 was distinctively associated with a decline in eGFR in men (0.6 mL/min/1.73 m2 per 100 pg/mL sTNF-R1; 95% CI: 0.4–0.8), but not in women. A similar association could not be found for CRP or IL-6. Estimates of sTNF-R1 in the cross-sectional analyses were similar between sexes, while CRP and IL-6 were not relevantly associated with eGFR/creatinine.ConclusionIn the elderly male general population with preserved renal function sTNF-R1 predicts the development of renal failure.
Highlights
The role of inflammation in the development of diseases is of major research interest in almost all fields of medicine including nephrology
Study population In our study population we found higher values of soluble tumour necrosis factor receptor type 1 (sTNF-R1) in men compared to females (Table 1), which held true for creatinine and estimated glomerular filtration rate (eGFR)
From baseline to follow-up we found an increase in creatinine and a decline in eGFR across the whole population
Summary
The role of inflammation in the development of diseases is of major research interest in almost all fields of medicine including nephrology. In a longitudinal analysis of patients with type 2 diabetes sTNF-R1 [7] and the second type of soluble tumour necrosis factor receptor (sTNF-R2) [7,8] were associated with a decline in glomerular filtration rate (GFR), which was similar to findings in a population-based cohort [9]. Taking these previous findings into account, sTNF-R1 might serve as a promising biomarker for predicting a decline in renal function in asymptomatic persons in the general population. There is evidence that chronic inflammation is associated with the progression/development of chronic renal failure; relations in subjects with preserved renal function remain insufficiently understood
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