Inflammation and renal function after a four-year follow-up in subjects with unimpaired glomerular filtration rate: results from the observational, population-based CARLA cohort

PLoS One. 2014 Sep 26;9(9):e108427. doi: 10.1371/journal.pone.0108427. eCollection 2014.

Abstract

Background: There 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.

Objective: To examine the association of inflammation with the development of renal failure in a cohort of the elderly general population.

Methods: After 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.

Results: In 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.

Conclusion: In the elderly male general population with preserved renal function sTNF-R1 predicts the development of renal failure.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / metabolism
  • Creatinine / blood
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Inflammation / blood
  • Inflammation / physiopathology*
  • Kidney / physiopathology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / physiopathology*

Substances

  • C-Reactive Protein
  • Creatinine

Grants and funding

The CARLA study was supported by a grant from the Deutsche Forschungsgemeinschaft as part of the Collaborative Research Centre 598 ‘Heart failure in the elderly – cellular mechanisms and therapy’ at the Medical Faculty of the Martin-Luther-University Halle-Wittenberg, by a grant from the Wilhelm-Roux Programme of the Martin-Luther-University Halle-Wittenberg, by the Ministry of Education and Cultural Affairs of Saxony-Anhalt, and by the Federal Employment Office. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.