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Title: | C-Reactive Protein and Risk of ESRD: Results From the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT) |
Authors: | CAUSLAND, Finnian R. Mc; CLAGGETT, Brian; BURDMANN, Emmanuel A.; ECKARDT, Kai-Uwe; KEWALRAMANI, Reshma; LEVEY, Andrew S.; MCMURRAY, John J. V.; PARFREY, Patrick; REMUZZI, Giuseppe; SINGH, Ajay K.; SOLOMON, Scott D.; TOTO, Robert D.; PFEFFER, Marc A. |
Citation: | AMERICAN JOURNAL OF KIDNEY DISEASES, v.68, n.6, p.873-881, 2016 |
Abstract: | Background: To better understand a potential association of elevated C-reactive protein (CRP) level with progression of chronic kidney disease (CKD), we examined the relationship of CRP level with the development of end-stage renal disease (ESRD) in the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). Study Design: Post hoc analysis of a randomized controlled trial. Setting & Participants: 4,038 patients with type 2 diabetes, CKD, and anemia in TREAT. Predictor: Baseline serum CRP concentrations. Outcomes: The primary outcome was development of ESRD; secondary outcomes included doubling of serum creatinine level, a composite of ESRD/serum creatinine doubling, and a composite of death or ESRD. Measurements: We fit unadjusted and adjusted Cox regression models to test the association of baseline CRP level with time to the development of the outcomes of interest. Results: Mean age of participants was 67 years, 43% were men, and 64% were white. Approximately half (48%) the patients had CRP levels. 3.0 mg/L; 668 patients developed ESRD, and 1,270 developed the composite outcome of death or ESRD. Compared with patients with baseline CRP levels #3.0 mg/L, those with moderately/markedly elevated CRP levels (>= 6.9 mg/L; 24% of patients) had a higher adjusted risk for ESRD (HR, 1.32; 95% CI, 1.07-1.63) and the composite outcome of death or ESRD (HR, 1.41; 95% CI, 1.21-1.64). Although nonsignificant, similar trends were noted in competing-risk models. Limitations: Results may not be generalizable to nondiabetic CKD or diabetic CKD in the absence of anemia. Conclusions: Elevated baseline CRP levels are common in type 2 diabetic patients with anemia and CKD and are associated with the future development of ESRD and the composite of death or ESRD. (C) 2016 by the National Kidney Foundation, Inc. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCM Artigos e Materiais de Revistas Científicas - LIM/12 Artigos e Materiais de Revistas Científicas - ODS/03 |
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