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Filtration Markers, Cardiovascular Disease, Mortality, and Kidney Outcomes in Stable Kidney Transplant Recipients: The FAVORIT Trial.
Foster, M C; Weiner, D E; Bostom, A G; Carpenter, M A; Inker, L A; Jarolim, P; Joseph, A A; Kusek, J W; Pesavento, T; Pfeffer, M A; Rao, M; Solomon, S D; Levey, A S.
Afiliación
  • Foster MC; Division of Nephrology, Tufts Medical Center, Boston, MA.
  • Weiner DE; Division of Nephrology, Tufts Medical Center, Boston, MA.
  • Bostom AG; Rhode Island Hospital, Providence, RI.
  • Carpenter MA; Department of Biostatistics, University of North Carolina, Chapel Hill, NC.
  • Inker LA; Division of Nephrology, Tufts Medical Center, Boston, MA.
  • Jarolim P; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Joseph AA; Division of Nephrology, Tufts Medical Center, Boston, MA.
  • Kusek JW; National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
  • Pesavento T; The Ohio State University Medical Center, Columbus, OH.
  • Pfeffer MA; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Rao M; Division of Nephrology, Tufts Medical Center, Boston, MA.
  • Solomon SD; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Levey AS; Division of Nephrology, Tufts Medical Center, Boston, MA.
Am J Transplant ; 17(9): 2390-2399, 2017 Sep.
Article en En | MEDLINE | ID: mdl-28257169
Cystatin C and beta-2-microglobulin (B2M) are filtration markers associated with adverse outcomes in nontransplant populations, sometimes with stronger associations than for creatinine. We evaluated associations of estimated glomerular filtration rate from cystatin C (eGFRcys ), B2M (eGFRB2M ), and creatinine (eGFRcr ) with cardiovascular outcomes, mortality, and kidney failure in stable kidney transplant recipients using a case-cohort study nested within the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) Trial. A random subcohort was selected (N = 508; mean age 51.6 years, median transplant vintage 4 years, 38% women, 23.6% nonwhite race) with enrichment for cardiovascular events (N = 306; 54 within the subcohort), mortality (N = 208; 68 within the subcohort), and kidney failure (N = 208; 52 within the subcohort). Mean eGFRcr , eGFRcys , and eGFRB2M were 46.0, 43.8, and 48.8 mL/min/1.73m2 , respectively. After multivariable adjustment, hazard ratios for eGFRcys and eGFRB2M <30 versus 60+ were 2.02 (95% confidence interval [CI] 1.09-3.76; p = 0.03) and 2.56 (1.35-4.88; p = 0.004) for cardiovascular events; 3.92 (2.11-7.31) and 4.09 (2.21-7.54; both p < 0.001) for mortality; and 9.49 (4.28-21.00) and 15.53 (6.99-34.51; both p < 0.001) for kidney failure. Associations persisted with additional adjustment for baseline eGFRcr . We conclude that cystatin C and B2M are strongly associated with cardiovascular events, mortality, and kidney failure in stable kidney transplant recipients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Biomarcadores / Enfermedades Cardiovasculares / Mortalidad / Trasplante de Riñón / Rechazo de Injerto / Fallo Renal Crónico Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Biomarcadores / Enfermedades Cardiovasculares / Mortalidad / Trasplante de Riñón / Rechazo de Injerto / Fallo Renal Crónico Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos