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Plasma Neutrophil Gelatinase-Associated Lipocalin Associates with New-Onset Chronic Kidney Disease in the General Population
oleh: Arno R. Bourgonje, Amaal E. Abdulle, Martin F. Bourgonje, Lyanne M. Kieneker, Sacha la Bastide-van Gemert, Sanne J. Gordijn, Clara Hidden, Tom Nilsen, Ron T. Gansevoort, Douwe J. Mulder, Robin P. F. Dullaart, Martin H. de Borst, Stephan J. L. Bakker, Harry van Goor
| Format: | Article |
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| Diterbitkan: | MDPI AG 2023-02-01 |
Deskripsi
Circulating levels of neutrophil gelatinase-associated lipocalin (NGAL) have been associated with acute kidney injury and the severity and progression of chronic kidney disease (CKD). This study investigated its potential utility as a biomarker for the risk of new-onset CKD in a population-based cohort study. Individuals without CKD at baseline (n = 4660) who participated in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) prospective population-based cohort study in the Netherlands were included. Baseline plasma NGAL concentrations were investigated for their associations with new-onset CKD, defined as a composite outcome of an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m<sup>2</sup>, urinary albumin excretion (UAE) > 30 mg/24-h, or both. Mean (±SD) plasma NGAL concentrations were 104.0 (±34.7) μg/L and median eGFR was 96 [IQR: 85.3–105.8] mL/min/1.73 m<sup>2</sup>. After median follow-up of 8.3 [IQR: 7.8–8.9] years, 467 participants developed new-onset CKD. Plasma NGAL concentrations were significantly associated with an increased risk of new-onset CKD (hazard ratio [HR] per doubling 1.35 [95% CI: 1.11–1.63], <i>p</i> = 0.002), even after adjustment for potentially confounding factors (1.37 [1.09–1.73], <i>p</i> = 0.007) except baseline eGFR (1.09 [0.86–1.37], <i>p</i> = 0.490). In secondary analyses, plasma NGAL concentrations were significantly associated with new-onset CKD as defined by eGFR < 60 mL/min/1.73 m<sup>2</sup> alone (adjusted HR per doubling 2.54 [1.69–3.80], <i>p</i> < 0.001), which was abrogated after adjustment for eGFR (1.05 [0.69–1.59], <i>p</i> = 0.828), also when UAE > 30 mg/24-h was set as individual outcome (1.05 [0.82–1.35], <i>p</i> = 0.705). Higher plasma NGAL concentrations are associated with an increased risk of developing CKD in the general population. This association is dependent on renal function, and mainly driven by new-onset CKD as defined by renal function decline.