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Increased urinary cystatin C indicated higher risk of cardiovascular death in a community cohort
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Dalarna University, School of Education, Health and Social Studies, Medical Science. Department of Medical Sciences, Uppsala University, Uppsala, Sweden ; Science for Life Laboratory, Uppsala University, Uppsala, Sweden.ORCID iD: 0000-0002-6933-4637
Department of Medical Sciences, Uppsala University, Uppsala, Sweden ; Science for Life Laboratory, Uppsala University, Uppsala, Sweden ; Centre for Family and Community Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
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2014 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 234, no 1, 108-113 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Urinary cystatin C (u-CysC) is a new biomarker for acute tubular kidney dysfunction and may also indicate chronic tubular dysfunction. Chronic kidney disease is an important cardiovascular risk factor, however it is not known if u-CysC is a risk marker for cardiovascular death.

METHODS: The association between u-CysC and cardiovascular mortality was investigated in a Swedish community-based cohort of 604 men aged 78 years. During follow-up (mean 6.7 years), 203 participants died, of which 90 due to cardiovascular causes.

RESULTS: High u-CysC (>0.029 mg/mmol Cr) was associated with a more than 2-fold risk of cardiovascular death (multivariable hazard ratio for quintile 5 vs. 1: 2.5, 95% CI 1.2-5.2, P < 0.05) in Cox regression models independent of cardiovascular risk factors, glomerular filtration rate (eGFR) and urinary Albumin. Participants with low eGFR (≤60 mL/min), albuminuria (≥3 mg/mmol Cr) and high u-CysC (>0.029 mg/mmol Cr) combined had a significantly higher cardiovascular mortality risk compared to participants with one or two of these biomarkers normal (hazard ratio 15, 95% CI: 6.7-36, P < 0.001, compared to all three biomarkers normal).

CONCLUSIONS: This study is the first to show that increased concentrations of the tubular kidney biomarker u-CysC indicated risk of cardiovascular death independently of other cardiovascular risk factors, glomerular filtration and albuminuria. Additional research is needed to further establish the usefulness of u-CysC in clinical practice.

Place, publisher, year, edition, pages
2014. Vol. 234, no 1, 108-113 p.
Keyword [en]
Chronic kidney disease; Risk factors; Mortality; Epidemiology; Atherosclerosis
National Category
Clinical Medicine
Research subject
Hälsa och välfärd
Identifiers
URN: urn:nbn:se:du-14216DOI: 10.1016/j.atherosclerosis.2014.02.020ISI: 000334337300018PubMedID: 24637410OAI: oai:DiVA.org:du-14216DiVA: diva2:723500
Available from: 2014-06-10 Created: 2014-06-10 Last updated: 2015-07-01Bibliographically approved

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