Apolipoprotein A-IV concentrations and clinical outcomes in a large chronic kidney disease cohort: Results from the GCKD study
Schwaiger JP, Kollerits B, Steinbrenner I, Weissensteiner H, Schoenherr S, Forer L, Kotsis F, Lamina C, Schneider M, Schultheiss UT, Wanner C, Koettgen A, Eckardt KU, Kronenberg F (2022)
Publication Type: Journal article
Publication year: 2022
Journal
DOI: 10.1111/joim.13437
Abstract
Background Chronic kidney disease (CKD) represents a chronic proinflammatory state and is associated with very high cardiovascular risk. Apolipoprotein A-IV (apoA-IV) has antiatherogenic, antioxidative, anti-inflammatory and antithrombotic properties and levels increase significantly during the course of CKD. Objectives We aimed to investigate the association between apoA-IV and all-cause mortality and cardiovascular outcomes in the German Chronic Kidney Disease study. Methods This was a prospective cohort study including 5141 Caucasian patients with available apoA-IV measurements and CKD. The majority of the patients had an estimated glomerular filtration rate (eGFR) of 30-60 ml/min/1.73m(2) or an eGFR >60 ml/min/1.73m(2) in the presence of overt proteinuria. Median follow-up was 6.5 years. The association of apoA-IV with comorbidities at baseline and endpoints during follow-up was modelled adjusting for major confounders. Results Mean apoA-IV concentrations of the entire cohort were 28.9 +/- 9.8 mg/dl. Patients in the highest apoA-IV quartile had the lowest high-sensitivity C-reactive protein values despite the highest prevalence of diabetes, albuminuria and the lowest eGFR. Each 10 mg/dl higher apoA-IV translated into lower odds of prevalent cardiovascular disease (1289 cases, odds ratio = 0.80, 95% confidence interval [CI] 0.72-0.86, p = 0.0000003). During follow-up, each 10 mg/dl higher apoA-IV was significantly associated with a lower risk for all-cause mortality (600 cases, hazard ratio [HR] = 0.81, 95% CI 0.73-0.89, p = 0.00004), incident major adverse cardiovascular events (506 cases, HR = 0.88, 95% CI 0.79-0.99, p = 0.03) and death or hospitalizations due to heart failure (346 cases, HR = 0.84, 95% CI 0.73-0.96, p = 0.01). Conclusions These data support a link between elevated apoA-IV concentrations and reduced inflammation in moderate CKD. ApoA-IV appears to be an independent risk marker for reduced all-cause mortality, cardiovascular events and heart failure in a large cohort of patients with CKD.
Authors with CRIS profile
Markus Schneider
Medizinische Fakultät
Kai-Uwe Eckardt
Department of Medicine 4 – Nephrology and Hypertension
Involved external institutions
Medizinische Universität Innsbruck
Austria (AT)
Albert-Ludwigs-Universität Freiburg
Germany (DE)
Universitätsklinikum Würzburg
Germany (DE)
Austria (AT)
Albert-Ludwigs-Universität Freiburg
Germany (DE)
Universitätsklinikum Würzburg
Germany (DE)
How to cite
APA:
Schwaiger, J.P., Kollerits, B., Steinbrenner, I., Weissensteiner, H., Schoenherr, S., Forer, L.,... Kronenberg, F. (2022). Apolipoprotein A-IV concentrations and clinical outcomes in a large chronic kidney disease cohort: Results from the GCKD study. Journal of Internal Medicine. https://doi.org/10.1111/joim.13437
MLA:
Schwaiger, Johannes P., et al. "Apolipoprotein A-IV concentrations and clinical outcomes in a large chronic kidney disease cohort: Results from the GCKD study." Journal of Internal Medicine (2022).
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