Predictive abilities of cardiovascular biomarkers to rapid decline of renal function in Chinese community-dwelling population: a 5-year prospective analysis

BMC Nephrol. 2017 Nov 9;18(1):331. doi: 10.1186/s12882-017-0743-y.

Abstract

Background: Predictive abilities of cardiovascular biomarkers to renal function decline are more significant in Chinese community-dwelling population without glomerular filtration rate (GFR) below 60 ml/min/1.73m2, and long-term prospective study is an optimal choice to explore this problem. Aim of this analysis was to observe this problem during the follow-up of 5 years.

Methods: In a large medical check-up program in Beijing, there were 948 participants with renal function evaluated at baseline and follow-up of 5 years. Physical examinations were performed by well-trained physicians. Blood samples were analyzed by qualified technicians in central laboratory.

Results: Median rate of renal function decline was 1.46 (0.42-2.91) mL/min/1.73m2/year. Rapid decline of renal function had a prevalence of 23.5% (223 participants). Multivariate linear and Logistic regression analyses confirmed that age, sex, baseline GFR, homocysteine and N-terminal pro B-type natriuretic peptide (NT-proBNP) had independently predictive abilities to renal function decline rate and rapid decline of renal function (p < 0.05 for all). High-sensitivity cardiac troponin T (hs-cTnT), carotid femoral pulse wave velocity and central augmentation index had no statistically independent association with renal function decline rate and rapid decline of renal function (p > 0.05 for all).

Conclusions: Homocysteine and NT-proBNP rather than hs-cTnT had independently predictive abilities to rapid decline of renal function in Chinese community-dwelling population without GFR below 60 ml/min/1.73m2. Baseline GFR was an independent factor predicting the rapid decline of renal function. Arterial stiffness and compliance had no independent effect on rapid decline of renal function. This analysis has a significant implication for public health, and changing the homocysteine and NT-proBNP levels might slow the rapid decline of renal function.

Keywords: Arterial stiffness and compliance; Cardiovascular biomarkers; Chinese community-dwelling population; Glomerular filtration rate; Rapid decline of renal function.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People*
  • Biomarkers / blood
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate / physiology*
  • Homocysteine / blood
  • Humans
  • Independent Living / trends*
  • Kidney Diseases / blood*
  • Kidney Diseases / diagnosis
  • Kidney Diseases / epidemiology
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Population Surveillance* / methods
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Factors
  • Time Factors

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Homocysteine
  • Natriuretic Peptide, Brain