C-reactive protein is associated with renal function abnormalities in a non-diabetic population

Stuveling, Erik M.; Hillege, Hans L.; Bakker, Stephan J. L.; Gans, Reinold; Jong, Paul E. de; Zeeuw, Dick de

doi:10.1046/j.1523-1755.2003.00762.x

Cited by 213 publications

(169 citation statements)

References 44 publications

(6 reference statements)

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“…Renal insufficiency, a condition whereby endothelial dysfunction is pervasive (22), very frequently is accompanied by raised CRP. CRP was found recently to be associated with a subtle reduction in creatinine clearance in the Prevention of Renal and Vascular Endstage Disease (PREVEND) study (23). In keeping with these observations, we reported that CRP was related inversely both with the vasodilatory response to ACh and with renal function.…”

Section: Discussionsupporting

confidence: 88%

Inflammation as a Mediator of the Link between Mild to Moderate Renal Insufficiency and Endothelial Dysfunction in Essential Hypertension

Zoccali¹,

Maio²,

Tripepi³

et al. 2006

Journal of the American Society of Nephrology

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M ild to moderate renal insufficiency now has emerged fully as a major public health problem. Population-based studies (1) and secondary analyses of intervention studies in hypertensive patients (2) and in selected patients at high cardiovascular risk (3) have shown coherently that classical risk factors such as hypertension, diabetes, hyperlipidemia, smoking, and overweight/obesity represent major correlates of renal dysfunction. Although its importance for prevention is still debated, convincing evidence was provided recently that low-grade inflammation, as measured by highly-sensitivity C-reactive protein (CRP), is an early marker of renal dysfunction and of cardiovascular events in the general population (4) and a risk factor for cardiovascular complications and progressive renal insufficiency in patients with chronic kidney disease (CKD) (5). We recently reported an association between mild to moderate renal impairment and the hemodynamic response to acetylcholine (ACh), an established test of endothelial function, in a large group of nevertreated individuals with uncomplicated essential hypertension (6). A corollary finding in this study was that renal function also was associated with serum CRP, suggesting that inflammation may be a critical factor mediating endothelial dysfunction and renal insufficiency in individuals with essential hypertension. Although merely associative, these observations in a carefully selected population of hypertensive individuals are important in that they may be hypothesis generating for understanding the high risk associated with mild to moderate renal insufficiency.In this study, we therefore performed a secondary analysis in the same database to test the influence of inflammation, as measured by serum CRP, on the association between altered hemodynamic response to ACh and mild to moderate renal insufficiency in individuals with essential hypertension. This analysis, based on multivariate modeling, suggests that inflammation is a critical factor in the chain of events that lead to renal dysfunction in hypertensive individuals.

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Section: Discussionsupporting

confidence: 88%

Inflammation as a Mediator of the Link between Mild to Moderate Renal Insufficiency and Endothelial Dysfunction in Essential Hypertension

Zoccali¹,

Maio²,

Tripepi³

et al. 2006

Journal of the American Society of Nephrology

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“…Multivariate linear regression analysis was used to investigate the cross-sectional relations between WHR and BMI, respectively, with renal hemodynamics, with adjustment for sex, age and MAP. In line with general population studies using creatinine clearance or eGFR, 59 the relation of age with GFR was nonlinear and was better described with addition of a quadratic term of age in the regression models. To test whether effects of WHR on renal hemodynamics were independent of BMI, the latter was forced into the model that tested the effects of WHR.…”

Section: Statistical Analysesmentioning

confidence: 58%

Central Body Fat Distribution Associates with Unfavorable Renal Hemodynamics Independent of Body Mass Index

Kwakernaak

Zelle

Bakker

et al. 2013

Journal of the American Society of Nephrology

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Central distribution of body fat is associated with a higher risk of renal disease, but whether it is the distribution pattern or the overall excess weight that underlies this association is not well understood. Here, we studied the association between waist-to-hip ratio (WHR), which reflects central adiposity, and renal hemodynamics in 315 healthy persons with a mean body mass index (BMI) of 24.9 kg/m 2 and a mean 125 I-iothalamate GFR of 109 ml/min per 1.73 m 2 . In multivariate analyses, WHR was associated with lower GFR, lower effective renal plasma flow, and higher filtration fraction, even after adjustment for sex, age, mean arterial pressure, and BMI. Multivariate models produced similar results regardless of whether the hemodynamic measures were indexed to body surface area. Thus, these results suggest that central body fat distribution, independent of BMI, is associated with an unfavorable pattern of renal hemodynamic measures that could underlie the increased renal risk reported in observational studies.

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“…22 We similarly showed that higher quartiles of CRP levels are associated with a higher relative risk of impaired glomerular filtration, after adjustment for other factors associated with a raised CRP level. 23 …”

Section: The Mechanism Of Obesity-induced Renal Damagementioning

confidence: 99%

Obesity and target organ damage: the kidney

et al. 2002

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Obesity is a risk marker for progressive renal function loss in patients with known renal disease. There is, however, increasing evidence that obesity may also damage the kidney in otherwise healthy subjects. There appears to be an intriguing parallel between the renal effects of obesity and those of diabetes. First, an increased renal blood flow and glomerular filtration rate has been described in obesity and, second, microalbuminuria is found to be related to obesity. These two events are known to predict future loss of renal function in diabetes. The mechanism responsible for the renal damage in obesity has not been established but there is evidence suggesting that this might be related to both hormonal changes as well as low-grade inflammation.

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C-reactive protein is associated with renal function abnormalities in a non-diabetic population

Cited by 213 publications

References 44 publications

Inflammation as a Mediator of the Link between Mild to Moderate Renal Insufficiency and Endothelial Dysfunction in Essential Hypertension

Inflammation as a Mediator of the Link between Mild to Moderate Renal Insufficiency and Endothelial Dysfunction in Essential Hypertension

Central Body Fat Distribution Associates with Unfavorable Renal Hemodynamics Independent of Body Mass Index

Obesity and target organ damage: the kidney

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