Korean J Intern Med.
2019 Jul;34(4):858-866. 10.3904/kjim.2017.058.
Circulating renalase predicts all-cause mortality and renal outcomes in patients with advanced chronic kidney disease
- Affiliations
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- 1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. kyna@snubh.org
- 2Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
- 3Department of Internal Medicine, National Medical Center, Seoul, Korea.
- 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 5Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
- 6Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
- 7Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
- 8Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea.
- 9Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 10Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
- 11Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
- 12Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
- 13Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
- 14Department of Medical Science, Seoul National University Graduate School, Seoul, Korea.
- 15Kidney Research Institute, Seoul National University, Seoul, Korea.
- KMID: 2457316
- DOI: http://doi.org/10.3904/kjim.2017.058
Abstract
- BACKGROUND/AIMS
Patients with chronic kidney disease (CKD) have been found to show markedly increased rates of end-stage renal disease, major adverse cardiovascular and cerebrovascular events (MACCEs), and mortality. Therefore, new biomarkers are required for the early detection of such clinical outcomes in patients with CKD. We aimed to determine whether the level of circulating renalase was associated with CKD progression, MACCEs, and all-cause mortality, using data from a prospective randomized controlled study, Kremezin STudy Against Renal disease progression in Korea (K-STAR; NCT 00860431).
METHODS
A retrospective analysis of the K-STAR data was performed including 383 patients with CKD (mean age, 56.4 years; male/female, 252/131). We measured circulating renalase levels and examined the effects of these levels on clinical outcomes.
RESULTS
The mean level of serum renalase was 75.8 ± 34.8 μg/mL. In the multivariable analysis, lower hemoglobin levels, higher serum creatinine levels, and diabetes mellitus were significantly associated with a higher renalase levels. Over the course of a mean follow-up period of 56 months, 25 deaths and 61 MACCEs occurred. Among 322 patients in whom these outcomes were assessed, 137 adverse renal outcomes occurred after a mean follow-up period of 27.8 months. Each 10-μg/mL increase in serum renalase was associated with significantly greater hazards of all-cause mortality and adverse renal outcomes (hazard ratio [HR] = 1.112, p = 0.049; HR = 1.052, p = 0.045). However, serum renalase level was not associated with the rate of MACCEs in patients with CKD.
CONCLUSIONS
Our results indicated that circulating renalase might be a predictor of mortality and adverse renal outcomes in patients with CKD.
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