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Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Sci+Rep 2017 ; 7 (ä): ä Nephropedia Template TP
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TMAO is Associated with Mortality: Impact of Modestly Impaired Renal Function #MMPMID29061990
Trimethylamine-N-Oxide (TMAO) is a microbiome-related metabolite that is cleared by the kidney and linked to renal function. We explored the relationship between TMAO and all-cause mortality, and determined whether this association was modified by renal function. A prospective study was performed among PREVEND participants to examine associations of plasma TMAO with all-cause mortality. After median follow-up of 8.3 years in 5,469 participants, 322 subjects died. TMAO was positively associated with age, body mass index, type 2 diabetes mellitus and inversely with estimated glomerular filtration rate (eGFRcreatcysC)(all P?0.001). Subjects in the highest versus lowest TMAO quartile had a crude 1.86-fold higher mortality risk (Ptrend?0.001). After adjustment for several risk factors, TMAO remained associated with all-cause mortality [HR:1.36 (95% CI, 0.97?1.91),Ptrend?=?0.016]. This association was lost after further adjustment for urinary albumin excretion and eGFR [HR:1.15 (95% CI, 0.81?1.64),Ptrend?=?0.22]. The association of TMAO with mortality was modified by eGFR in crude and age- and sex-adjusted analyses (interaction P?=?0.002). When participants were stratified by renal function (eGFR < vs. ?90?mL/min/1.73?m2), TMAO was associated with all-cause mortality only in subjects with eGFR <90?mL/min/1.73?m2 [adjusted HR:1.18 (95% CI, 1.02?1.36),P?=?0.023]. In conclusion, TMAO is associated with all-cause mortality, particularly in subjects with eGFR <90?mL/min/1.73?m2.