Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis
<p>Abstract</p> <p>Background</p> <p>Defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, chronic kidney disease (CKD) is strongly and independently associated with cardiovascular and overall mortality. We hypothesized that reduced kidney funct...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2011-01-01
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| Series: | BMC Nephrology |
| Online Access: | http://www.biomedcentral.com/1471-2369/12/3 |
| _version_ | 1818788043561107456 |
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| author | Peralta Carmen A Palmas Walter Fried Linda F Folsom Aaron R Cushman Mary Dubin Ruth Wassel Christina Shlipak Michael G |
| author_facet | Peralta Carmen A Palmas Walter Fried Linda F Folsom Aaron R Cushman Mary Dubin Ruth Wassel Christina Shlipak Michael G |
| author_sort | Peralta Carmen A |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, chronic kidney disease (CKD) is strongly and independently associated with cardiovascular and overall mortality. We hypothesized that reduced kidney function would be characterized by abnormalities of hemostasis.</p> <p>Methods</p> <p>We tested cross-sectional associations between (eGFR) and multiple hemostatic markers among 6751 participants representing a broad spectrum of kidney function in the Multi-Ethnic Study of Atherosclerosis (MESA). Kidney function was measured using cystatin C (eGFRcys) or creatinine, using CKD Epidemiology Collaboration (eGFRcr). Hemostatic markers included soluble thrombomodulin (sTM), soluble tissue factor (sTF), D-Dimer, von Willebrand factor (vWF), factor VIII, plasmin-antiplasmin complex (PAP), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor-1 (PAI-1), and fibrinogen. Associations were tested using multivariable linear regression with adjustment for demographics and comorbidities.</p> <p>Results</p> <p>In comparison to persons with eGFRcys >90 ml/min/1.73 m<sup>2</sup>, subjects with eGFRcys < 60 ml/min/1.73 m<sup>2 </sup>had adjusted levels of sTM, sTF, D-Dimer, PAP, Factor VIII, TFPI, vWF and fibrinogen that were respectively 86%, 68%, 44%, 22%, 17%, 15%, 12% and 6% higher. Subjects with eGFRcys 60-90 ml/min/1.73 m<sup>2 </sup>had adjusted levels that were respectively 16%, 14%, 12%, 6%, 6%, 6%, 11% and 4% higher (p < 0.05 for all). Percent differences were not significantly different when groups were categorized by eGFRcr.</p> <p>Conclusions</p> <p>Throughout a broad spectrum of kidney function, lower eGFR was associated with higher levels of hemostatic markers. Dysregulation of hemostasis may be a mechanism by which reduced kidney function promotes higher cardiovascular risk.</p> |
| first_indexed | 2024-12-18T14:17:24Z |
| format | Article |
| id | doaj.art-23eccc7966544a1090c2ae72b235f44d |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-18T14:17:24Z |
| publishDate | 2011-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-23eccc7966544a1090c2ae72b235f44d2022-12-21T21:04:57ZengBMCBMC Nephrology1471-23692011-01-01121310.1186/1471-2369-12-3Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosisPeralta Carmen APalmas WalterFried Linda FFolsom Aaron RCushman MaryDubin RuthWassel ChristinaShlipak Michael G<p>Abstract</p> <p>Background</p> <p>Defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, chronic kidney disease (CKD) is strongly and independently associated with cardiovascular and overall mortality. We hypothesized that reduced kidney function would be characterized by abnormalities of hemostasis.</p> <p>Methods</p> <p>We tested cross-sectional associations between (eGFR) and multiple hemostatic markers among 6751 participants representing a broad spectrum of kidney function in the Multi-Ethnic Study of Atherosclerosis (MESA). Kidney function was measured using cystatin C (eGFRcys) or creatinine, using CKD Epidemiology Collaboration (eGFRcr). Hemostatic markers included soluble thrombomodulin (sTM), soluble tissue factor (sTF), D-Dimer, von Willebrand factor (vWF), factor VIII, plasmin-antiplasmin complex (PAP), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor-1 (PAI-1), and fibrinogen. Associations were tested using multivariable linear regression with adjustment for demographics and comorbidities.</p> <p>Results</p> <p>In comparison to persons with eGFRcys >90 ml/min/1.73 m<sup>2</sup>, subjects with eGFRcys < 60 ml/min/1.73 m<sup>2 </sup>had adjusted levels of sTM, sTF, D-Dimer, PAP, Factor VIII, TFPI, vWF and fibrinogen that were respectively 86%, 68%, 44%, 22%, 17%, 15%, 12% and 6% higher. Subjects with eGFRcys 60-90 ml/min/1.73 m<sup>2 </sup>had adjusted levels that were respectively 16%, 14%, 12%, 6%, 6%, 6%, 11% and 4% higher (p < 0.05 for all). Percent differences were not significantly different when groups were categorized by eGFRcr.</p> <p>Conclusions</p> <p>Throughout a broad spectrum of kidney function, lower eGFR was associated with higher levels of hemostatic markers. Dysregulation of hemostasis may be a mechanism by which reduced kidney function promotes higher cardiovascular risk.</p>http://www.biomedcentral.com/1471-2369/12/3 |
| spellingShingle | Peralta Carmen A Palmas Walter Fried Linda F Folsom Aaron R Cushman Mary Dubin Ruth Wassel Christina Shlipak Michael G Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis BMC Nephrology |
| title | Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
| title_full | Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
| title_fullStr | Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
| title_full_unstemmed | Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
| title_short | Kidney function and multiple hemostatic markers: cross sectional associations in the multi-ethnic study of atherosclerosis |
| title_sort | kidney function and multiple hemostatic markers cross sectional associations in the multi ethnic study of atherosclerosis |
| url | http://www.biomedcentral.com/1471-2369/12/3 |
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