Mc Causland, F. R. et al. (2016) C-Reactive protein and risk of ESRD: results from the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). American Journal of Kidney Diseases, 68(6), pp. 873-881. (doi: 10.1053/j.ajkd.2016.07.022) (PMID:27646425) (PMCID:PMC5123931)
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Abstract
Background: To better understand a potential association of elevated C-reactive protein (CRP) level with progression of chronic kidney disease (CKD), we examined the relationship of CRP level with the development of end-stage renal disease (ESRD) in the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). Study Design Post hoc analysis of a randomized controlled trial. Setting & Participants: 4,038 patients with type 2 diabetes, CKD, and anemia in TREAT. Predictor: Baseline serum CRP concentrations. Outcomes: The primary outcome was development of ESRD; secondary outcomes included doubling of serum creatinine level, a composite of ESRD/serum creatinine doubling, and a composite of death or ESRD. Measurements: We fit unadjusted and adjusted Cox regression models to test the association of baseline CRP level with time to the development of the outcomes of interest. Results: Mean age of participants was 67 years, 43% were men, and 64% were white. Approximately half (48%) the patients had CRP levels > 3.0 mg/L; 668 patients developed ESRD, and 1,270 developed the composite outcome of death or ESRD. Compared with patients with baseline CRP levels ≤ 3.0 mg/L, those with moderately/markedly elevated CRP levels (≥6.9 mg/L; 24% of patients) had a higher adjusted risk for ESRD (HR, 1.32; 95% CI, 1.07-1.63) and the composite outcome of death or ESRD (HR, 1.41; 95% CI, 1.21-1.64). Although nonsignificant, similar trends were noted in competing-risk models. Limitations: Results may not be generalizable to nondiabetic CKD or diabetic CKD in the absence of anemia. Conclusions: Elevated baseline CRP levels are common in type 2 diabetic patients with anemia and CKD and are associated with the future development of ESRD and the composite of death or ESRD.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | McMurray, Professor John |
Authors: | Mc Causland, F. R., Claggett, B., Burdmann, E. A., Eckardt, K.-U., Kewalramani, R., Levey, A. S., McMurray, J. J.V., Parfrey, P., Remuzzi, G., Singh, A. K., Solomon, S. D., Toto, R. D., and Pfeffer, M. A. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
Journal Name: | American Journal of Kidney Diseases |
Publisher: | Elsevier |
ISSN: | 0272-6386 |
ISSN (Online): | 1523-6838 |
Published Online: | 16 September 2016 |
Copyright Holders: | Copyright © 2016 Elsevier |
First Published: | First published in American Journal of Kidney Diseases 68(6):873-881 |
Publisher Policy: | Reproduced in accordance with the copyright policy of the publisher |
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