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Verfasst von:Yazdani, Babak [VerfasserIn]   i
 Delgado Gonzales de Kleber, Graciela [VerfasserIn]   i
 Scharnagl, Hubert [VerfasserIn]   i
 Krämer, Bernhard [VerfasserIn]   i
 Drexel, Heinz [VerfasserIn]   i
 März, Winfried [VerfasserIn]   i
 Scherberich, Jürgen E. [VerfasserIn]   i
 Leiherer, Andreas [VerfasserIn]   i
 Kleber, Marcus E. [VerfasserIn]   i
Titel:Combined use of serum uromodulin and eGFR to estimate mortality risk
Verf.angabe:Babak Yazdani, Graciela E. Delgado, Hubert Scharnagl, Bernhard K. Krämer, Heinz Drexel, Winfried März, Jürgen E. Scherberich, Andreas Leiherer and Marcus E. Kleber
E-Jahr:2021
Jahr:08 September 2021
Umfang:11 S.
Fussnoten:Gesehen am 26.10.2021
Titel Quelle:Enthalten in: Frontiers in medicine
Ort Quelle:Lausanne : Frontiers Media, 2014
Jahr Quelle:2021
Band/Heft Quelle:8(2021) vom: 8. Sept., Artikel-ID 723546, Seite 1-11
ISSN Quelle:2296-858X
Abstract:Serum uromodulin (sUmod) shows a strong direct correlation with eGFR in patients with impaired kidney function and an inverse association with mortality. However, there are patients in whom only one of both markers is decreased. Therefore, we aimed to investigate the effect of marker discordance on mortality risk. sUmod and eGFR were available in 3,057 participants of the Ludwigshafen Risk and Cardiovascular Health study and 529 participants of the VIVIT study. Both studies are monocentric prospective studies of patients that had been referred for coronary angiography. Participants were categorized into four groups according to the median values of sUmod (LURIC: 146 ng/ml, VIVIT: 156) and eGFR (LURIC: 84 ml/min/1.73 m2, VIVIT: 87). In 945 LURIC participants both markers were high (UHGH), in 935 both were low (ULGL), in 589 only eGFR (UHGL), and in 582 only sUmod (ULGH) was low. After balancing the groups for cardiovascular risk factors, hazard ratios (95%CI) for all-cause mortality as compared to UHGH were 2.03 (1.63-2.52), 1.43 (1.13-1.81), and 1.32 (1.03-1.69) for ULGL, UHGL, and ULGH, respectively. In VIVIT, HRs were 3.12 (1.38-7.08), 2.38 (1.01-5.61), and 2.06 (0.81-5.22). Adding uromodulin to risk prediction models that already included eGFR as a covariate slightly increased the Harrell's C and significantly improved the AUC in LURIC. In UHGL patients, hypertension, heart failure and upregulation of the renin-angiotensin-aldosterone-system seem to be the driving forces of disease development, whereas in ULGH patients metabolic disturbances might be key drivers of increased mortality. In conclusion, SUmod/eGFR subgroups mirror distinct metabolic and clinical patterns. Assessing sUmod additionally to creatinine or cystatin C has the potential to allow a more precise risk modeling and might improve risk stratification.
DOI:doi:10.3389/fmed.2021.723546
URL:kostenfrei: Volltext ; Verlag: https://doi.org/10.3389/fmed.2021.723546
 kostenfrei: Volltext: https://www.frontiersin.org/article/10.3389/fmed.2021.723546
 DOI: https://doi.org/10.3389/fmed.2021.723546
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1775320723
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