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Nephrol Dial Transplant. 2011 Jun;26(6):1903-8. doi: 10.1093/ndt/gfq648. Epub 2010 Nov 15.

Racial differences in the association of pentraxin-3 with kidney dysfunction: the Multi-Ethnic Study of Atherosclerosis.

Author information

  • 1Department of Medicine, Division of Nephrology, University of California San Francisco, San Francisco, CA, USA. ruth.dubin@ucsf.edu

Abstract

BACKGROUND:

Pentraxin-3 (PTX3), an inflammatory marker thought to be related to vascular inflammation, is elevated in advanced chronic kidney disease (CKD). Whether PTX3 is associated with mild to moderate kidney dysfunction is unknown.

METHODS:

We tested associations of proteins in the pentraxin family [PTX3, C-reactive protein (CRP) and serum amyloid protein (SAP)] with estimated glomerular filtration rate by cystatin C (eGFRcys) and microalbuminuria among 2824 participants in the Multi-Ethnic Study of Atherosclerosis. Associations were tested using multivariable linear regression with adjustment for demographics (age, gender, annual income), comorbidities (diabetes, hypertension, smoking, body mass index, low-density lipoprotein, high-density lipoprotein, triglycerides, ACE inhibitor and statin use) and systemic inflammation [interleukin-6 (IL-6)].

RESULTS:

Among the 2824 participants, mean age was 62 years and mean eGFRcys was 94 mL/min/1.73 m(2); 25% were white, 25% Chinese, 25% African-American and 25% Hispanic. Among all participants after full adjustment, higher PTX3 was associated with lower eGFRcys independently of IL-6 (β - 3.0 mL/min/1.73 m(2) per unit increase in lnPTX3, P < 0.001). In contrast, CRP and SAP were associated with eGFRcys in demographic adjusted models, but these associations were attenuated after adjustment for comorbidities and IL-6 (lnCRP β - 0.06, P = 0.9; lnSAP β - 0.35, P = 0.7). There was a significant interaction with race/ethnicity (P < 0.001) in the association of PTX3 and eGFRcys. After adjustment for demographics, comorbidities and IL-6, this association was significant in blacks (β - 5.7 mL/min/1.73 m(2) per unit increase in lnPTX3, P = 0.002) but not in Hispanics (β - 2.4, P = 0.1), Chinese (β - 0.91, P = 0.5) or whites (β - 0.26, P = 0.9). PTX3 and CRP, but not SAP, had correlations with microalbuminuria in unadjusted models (Spearman coefficients PTX3 0.05, P = 0.005; CRP 0.07, P < 0.001; SAP 0.013, P = 0.5), but these were attenuated after full adjustment.

CONCLUSIONS:

Endovascular inflammation may be an important mechanism associated with early kidney dysfunction, particularly among blacks. This mechanism appears to be independent of IL-6-regulated pathways.

PMID:
21079193
[PubMed - indexed for MEDLINE]
PMCID:
PMC3145399
Free PMC Article

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