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

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, Louise J. Maple-Brown

    Research output: Contribution to journalArticleResearchpeer-review

    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 eGFRwith a follow-up eGFR <60 mL/min/1.73m2, 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 (24.22 mL/min/1.73 m2/year [95% CI27.06 to 21.38]; 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.

    Original languageEnglish
    Pages (from-to)739-747
    Number of pages9
    JournalDiabetes Care
    Volume41
    Issue number4
    DOIs
    Publication statusPublished - 1 Apr 2018

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    Tumor Necrosis Factor Receptors
    Kidney Diseases
    Glomerular Filtration Rate
    Kidney
    Disease Progression
    Creatinine
    Albumins
    Urine
    Receptors, Tumor Necrosis Factor, Type I
    Blood Pressure
    Albuminuria
    Waist-Hip Ratio
    Renal Replacement Therapy
    C-Reactive Protein
    Observational Studies
    Longitudinal Studies
    Linear Models
    Research Design
    Serum
    Research

    Cite this

    Barr, Elizabeth L.M. ; Barzi, Federica ; Hughes, Jaquelyne T. ; Jerums, George ; Hoy, Wendy E. ; O'Dea, Kerin ; Jones, Graham R.D. ; Lawton, Paul D. ; Brown, Alex D.H. ; Thomas, Mark ; Ekinci, Elif I. ; Sinha, Ashim ; Cass, Alan ; MacIsaac, Richard J. ; Maple-Brown, Louise J. / 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. In: Diabetes Care. 2018 ; Vol. 41, No. 4. pp. 739-747.
    @article{b3025b489e0c4c758a3b665ca244893e,
    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",
    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 eGFRwith a follow-up eGFR <60 mL/min/1.73m2, 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 (24.22 mL/min/1.73 m2/year [95{\%} CI27.06 to 21.38]; 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.",
    author = "Barr, {Elizabeth L.M.} and Federica Barzi and Hughes, {Jaquelyne T.} and George Jerums and Hoy, {Wendy E.} and Kerin O'Dea and Jones, {Graham R.D.} and Lawton, {Paul D.} and Brown, {Alex D.H.} and Mark Thomas and Ekinci, {Elif I.} and Ashim Sinha and Alan Cass and MacIsaac, {Richard J.} and Maple-Brown, {Louise J.}",
    year = "2018",
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    doi = "10.2337/dc17-1919",
    language = "English",
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    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. / Barr, Elizabeth L.M.; Barzi, Federica; Hughes, Jaquelyne T.; Jerums, George; Hoy, Wendy E.; O'Dea, Kerin; Jones, Graham R.D.; Lawton, Paul D.; Brown, Alex D.H.; Thomas, Mark; Ekinci, Elif I.; Sinha, Ashim; Cass, Alan; MacIsaac, Richard J.; Maple-Brown, Louise J.

    In: Diabetes Care, Vol. 41, No. 4, 01.04.2018, p. 739-747.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - High baseline levels of tumor necrosis factor receptor 1 are associated with progression of kidney disease in indigenous australians with diabetes

    T2 - The eGFR follow-up study

    AU - Barr, Elizabeth L.M.

    AU - Barzi, Federica

    AU - Hughes, Jaquelyne T.

    AU - Jerums, George

    AU - Hoy, Wendy E.

    AU - O'Dea, Kerin

    AU - Jones, Graham R.D.

    AU - Lawton, Paul D.

    AU - Brown, Alex D.H.

    AU - Thomas, Mark

    AU - Ekinci, Elif I.

    AU - Sinha, Ashim

    AU - Cass, Alan

    AU - MacIsaac, Richard J.

    AU - Maple-Brown, Louise J.

    PY - 2018/4/1

    Y1 - 2018/4/1

    N2 - 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 eGFRwith a follow-up eGFR <60 mL/min/1.73m2, 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 (24.22 mL/min/1.73 m2/year [95% CI27.06 to 21.38]; 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.

    AB - 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 eGFRwith a follow-up eGFR <60 mL/min/1.73m2, 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 (24.22 mL/min/1.73 m2/year [95% CI27.06 to 21.38]; 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.

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    U2 - 10.2337/dc17-1919

    DO - 10.2337/dc17-1919

    M3 - Article

    VL - 41

    SP - 739

    EP - 747

    JO - Diabetes Care

    JF - Diabetes Care

    SN - 0149-5992

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    ER -