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Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Am+J+Hypertens 2016 ; 29 (4): 528-36 Nephropedia Template TP
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Increased Circulating Visfatin Is Associated With Progression of Kidney Disease in Non-Diabetic Hypertensive Patients #MMPMID26298010
Hsu CY; Huang PH; Chen TH; Chiang CH; Leu HB; Huang CC; Chen JW; Lin SJ
Am J Hypertens 2016[Apr]; 29 (4): 528-36 PMID26298010show ga
BACKGROUD: Declining renal function is an independent risk factor for all-cause mortality in cardiovascular disease. Visfatin has been described as a marker of inflammation and endothelial dysfunction, but whether circulating visfatin levels are predictive to a subsequent decline in renal function remains unclear. METHODS: In total, 200 nondiabetic, non-proteinuric hypertensive outpatients with initial serum creatinine (Scr) ?1.5mg/dl were enrolled. Plasma visfatin concentration and endothelial function estimated by brachial artery flow-mediated dilatation (FMD) were determined in the study subjects. The primary endpoints were the occurrence of renal events including doubling of Scr, 25% loss of glomerular filtration rate (GFR) from baseline values, and the occurrence of end-stage renal disease during follow-up. RESULTS: The mean annual rate of GFR decline (?GFR/y) was ?1.26±2.76ml/min/1.73 m2 per year during follow-up (8.6±2.5 years). At baseline, plasma visfatin was negatively correlated with estimated GFR. In longitudinal analysis, the ?GFR/y was correlated with visfatin, baseline GFR, FMD, systolic blood pressure, and fasting blood glucose (FBG). Multivariate analysis indicated that increased visfatin (r = ?0.331, P <0.001), baseline GFR (r = ?0.234, P = 0.001), FMD (r = 0.163, P = 0.015), and FBG (r = ?0.160, P = 0.015) are independent predictors of ?eGFR/y. Cox regression model analysis showed that visfatin (hazard ratio (HR), 1.09; 95% confidence interval (CI), 1.05?1.13, P <0.001), FBG (HR, 1.01; 95% CI, 1.00?1.02, P = 0.020), and FMD (HR, 0.87; 95% CI, 0.76?1.00, P = 0.049) were independently associated with the risk of developing future renal events. CONCLUSIONS: Increased circulating visfatin are associated with subsequent decline in renal function in nondiabetic hypertensive patients.