Estimated Glomerular Filtration Rate, Proteinuria, and Risk of Cardiovascular Diseases and All-cause Mortality in Diabetic Population: a Community-based Cohort Study

Wang, Anxin; Chen, Guojuan; Cao, Yibin; Liu, Xiaoxue; Su, Zhaoping; Luo, Yanxia; Zhao, Zhanzheng; Li, Xia; Chen, Shuohua; Wu, Shouling; Guo, Xiuhua

doi:10.1038/s41598-017-17965-z

Cited by 10 publications

(7 citation statements)

References 30 publications

(33 reference statements)

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“…We showed that 24 h proteinuria was an independent predictor of cardiocerebrovascular events, which is consistent with previous reports [24][25][26][27]. Higher aldosterone and lower α-klotho levels tended to be accompanied by a higher incidence of cardiocerebrovascular events, but this was not statistically significant.…”

Section: Discussionsupporting

confidence: 91%

Circulating α-Klotho is Related to Plasma Aldosterone and Its Follow-Up Change Predicts CKD Progression

Qian

Zhong

Yan

et al. 2018

Kidney Blood Press Res

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Background/Aims: We aimed to determine if soluble α-klotho level was an indicator of chronic kidney disease (CKD) progression and whether α-klotho interacted with aldosterone during the course of further renal damage. Methods: 112 adults with stages 1–5 CKD were enrolled into our cohort study. All of the patients were followed up for 6 years (from January 2010 to December 2015). Serum soluble α-klotho and aldosterone were measured at baseline and at 1.5-years follow-up. The primary outcome was the initiation of renal replacement therapy (RRT) and the secondary outcome was the occurrence of cardio-cerebrovascular events. Long-term progression to RRT and cardio-cerebrovascular events in patients was analyzed with a risk-adjusted Cox proportional hazards regression model. Adjustment included age, gender, eGFR, mean arterial pressure, 24-h protein excretion and the change in α-klotho level from baseline at 1.5-years follow-up. Results: Baseline circulating α-klotho levels were positively associated with baseline estimated glomerular filtration rate (eGFR; r = 0.224, p = 0.017), but not age, calcium, phosphate, or parathyroid hormone levels. The change in α-klotho level from baseline at 1.5-years follow-up (p = 0.002) was independently associated with renal replace treatment (RRT) initiation after adjustment for age, gender, eGFR, mean arterial pressure, and 24-h protein excretion in Cox regression analysis. Aldosterone levels were positively associated with CKD stage, and were inversely correlated with circulating α-klotho levels. Conclusion: The change in concentration of soluble α-klotho during the 1.5-years follow-up was an indicator of CKD progression. Renal damage associated with a reduction of α-klotho may involve the upregulation of plasma aldosterone. Future studies are needed to validate our findings, and to investigate the underlying mechanism by which α-klotho and aldosterone may cause renal damage.

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Section: Discussionsupporting

confidence: 91%

Circulating α-Klotho is Related to Plasma Aldosterone and Its Follow-Up Change Predicts CKD Progression

Qian

Zhong

Yan

et al. 2018

Kidney Blood Press Res

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“…Proteinuria results in undernutrition and inflammation, which are associated with poor outcomes in patients with chronic disease, even in the general population. 34 Importantly, patients with MM and a low AGR should be assessed for the presence of a strong inflammatory response, malnourishment, or both. Treatment with nutritional support and anti-inflammatory agents might reduce the risk of mortality in patients with MM.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of the albumin–globulin ratio and albumin–globulin score in patients with multiple myeloma

et al. 2021

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Objective The albumin–globulin ratio (AGR) has been identified as a promising prognostic predictor of mortality in patients with hematological malignancies. This study investigated the prognostic significance of AGR in patients with multiple myeloma. Methods Two hundred patients diagnosed with multiple myeloma from January 2010 to October 2018 were retrospectively analyzed and followed up until December 2019. Kaplan–Meier curves and multivariate Cox regression analysis were applied to detect the prognostic value of AGR. Results The median follow-up period was 36 months. The optimal cutoff of AGR was 1.16 according to receiver operating characteristic curve analysis. High AGR was significantly correlated with better overall survival (OS) and progression-free survival (PFS). Multivariate analysis revealed that low AGR was an independent prognostic factor for worse OS (hazard ratio [HR] = 1.82, 95% confidence interval [CI] = 1.15–2.94) and PFS (HR = 1.53, 95% CI = 1.09–2.17). Conclusions AGR may represent a potential prognostic biomarker in patients with multiple myeloma. Mini Abstract: We demonstrated that high AGR was associated with a favorable overall survival and progression-free survival in patients with multiple myeloma.

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“…A low AGR could be the consequence of transcapillary albumin loss [26], such as proteinuria. Proteinuria was associated with an increased risk for cardiovascular events and acute cerebrovascular disease, even in the general population [27,28]. Therefore, patients with low AGR may indicate vascular damage.…”

Section: Discussionmentioning

confidence: 99%

Albumin-globulin ratio and mortality in patients on peritoneal dialysis: a retrospective study

et al. 2020

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Background: Albumin-globulin ratio (AGR), a variable based on serum albumin and non-albumin proteins, has been demonstrated as a predictor of mortality in patients with malignant neoplasm. The aim of this study was to evaluate the prognostic value of AGR on peritoneal dialysis (PD) patients. Methods: We retrospectively analyzed 602 incident PD patients from January 1st, 2008, to December 31st, 2017, at our center and followed them until December 31st, 2018. Kaplan-Meier curves and multivariate Cox regression models were applied to analyze the association between AGR and all-cause of mortality and cardiovascular mortality. Results: The median follow-up time was 32.17 (interquartile range = 32.80) months. During follow-up, 131 (21.8%) patients died, including 57 patients (43.5%) who died due to cardiovascular diseases. Kaplan-Meier curves showed that patients with AGR > 1.26 had better rates of survival than those with AGR ≤ 1.25 (p < 0.001). After adjusting for potential confounders, the lower AGR level was significantly associated with an increased all-cause and cardiovascular mortality [hazard ratio (HR): 1.57, 95% confidence interval (CI): 1.07-2.32, p = 0.022 and HR: 2.01, 95% CI: 1.10-3.69, p = 0.023 respectively]. Conclusions: Patients with a low AGR level had an increased all-cause and cardiovascular mortality. AGR may be a useful index in identifying patients on PD at risk for CVD and all-cause of mortality.

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Estimated Glomerular Filtration Rate, Proteinuria, and Risk of Cardiovascular Diseases and All-cause Mortality in Diabetic Population: a Community-based Cohort Study

Cited by 10 publications

References 30 publications

Circulating α-Klotho is Related to Plasma Aldosterone and Its Follow-Up Change Predicts CKD Progression

Circulating α-Klotho is Related to Plasma Aldosterone and Its Follow-Up Change Predicts CKD Progression

Prognostic value of the albumin–globulin ratio and albumin–globulin score in patients with multiple myeloma

Albumin-globulin ratio and mortality in patients on peritoneal dialysis: a retrospective study

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