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Type: Journal article
Title: High baseline levels of tumor necrosis factor receptor 1 are associated with progression of kidney disease in Indigenous Australians with diabetes: the eGFR follow-up study
Author: Barr, E.L.
Barzi, F.
Hughes, J.T.
Jerums, G.
Hoy, W.E.
O'Dea, K.
Jones, G.R.
Lawton, P.D.
Brown, A.D.
Thomas, M.
Ekinci, E.I.
Sinha, A.
Cass, A.
MacIsaac, R.J.
Maple-Brown, L.J.
Citation: Diabetes Care, 2018; 41(4):739-747
Publisher: American Diabetes Association
Issue Date: 2018
ISSN: 0149-5992
Statement of
Elizabeth L.M. Barr, Federica Barzi, Jaquelyne T. Hughes, George Jerums, Wendy E. Hoy, Kerin O, Dea, Graham R.D. Jones, Paul D. Lawton, Alex D.H. Brown, Mark Thomas, Elif I. Ekinci, Ashim Sinha, Alan Cass, Richard J. MacIsaac, and Louise J. Maple-Brown
Abstract: OBJECTIVE To examine the association between soluble tumor necrosis factor receptor 1 (sTNFR1) levels and kidney disease progression in Indigenous Australians at high risk of kidney disease. RESEARCH DESIGN AND METHODS This longitudinal observational study examined participants aged ≥18 years recruited from >20 sites across diabetes and/or kidney function strata. Baseline measures included sTNFR1, serum creatinine, urine albumin-to-creatinine ratio (uACR), HbA1c, C-reactive protein (CRP), waist-to-hip ratio, systolic blood pressure, and medical history. Linear regression was used to estimate annual change in estimated glomerular filtration rate (eGFR) for increasing sTNFR1, and Cox proportional hazards were used to estimate the hazard ratio (HR) and 95% CI for developing a combined renal outcome (first of a ≥30% decline in eGFR with a follow-up eGFR <60 mL/min/1.73 m2, progression to renal replacement therapy, or renal death) for increasing sTNFR1. RESULTS Over a median of 3 years, participants with diabetes (n = 194) in the highest compared with the lowest quartile of sTNFR1 experienced significantly greater eGFR decline (−4.22 mL/min/1.73 m2/year [95% CI −7.06 to −1.38]; P = 0.004), independent of baseline age, sex, eGFR, and uACR. The adjusted HR (95% CI) for participants with diabetes per doubling of sTNFR1 for the combined renal outcome (n = 32) was 3.8 (1.1–12.8; P = 0.03). No association between sTNFR1 and either renal outcome was observed for those without diabetes (n = 259). CONCLUSIONS sTNFR1 is associated with greater kidney disease progression independent of albuminuria and eGFR in Indigenous Australians with diabetes. Further research is required to assess whether TNFR1 operates independently of other metabolic factors associated with kidney disease progression.
Keywords: Humans; Kidney Diseases; Diabetic Nephropathies; Albuminuria; Diabetes Mellitus, Type 2; Disease Progression; Receptors, Tumor Necrosis Factor, Type I; Glomerular Filtration Rate; Renal Replacement Therapy; Longitudinal Studies; Follow-Up Studies; Adult; Aged; Middle Aged; Population Groups; Australia; Female; Male
Rights: © 2018 by the American Diabetes Association.
RMID: 0030091798
DOI: 10.2337/dc17-1919
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Appears in Collections:Medicine publications

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