Plasma pentraxin 3 in patients with chronic kidney disease: associations with renal function, protein-energy wasting, cardiovascular disease, and mortality.
OBJECTIVE
Plasma protein pentraxin 3 concentrations are elevated in a wide range of diseased states. However, no study has evaluated protein pentraxin 3 in patients with chronic kidney disease.


METHODS
Plasma protein pentraxin 3 concentrations were analyzed in relation to GFR, inflammation, cardiovascular disease, and protein-energy wasting in 71 patients with stages 3 to 4 chronic kidney disease, 276 patients with stage 5 chronic kidney disease, and 61 control subjects. Survival (5 yr) in patients with stage 5 chronic kidney disease was analyzed in relation to protein pentraxin 3 levels.


RESULTS
Both patient groups with chronic kidney disease had higher protein pentraxin 3 concentrations than control subjects, with the highest concentration in patients with stage 5 chronic kidney disease. In all patients with chronic kidney disease, protein pentraxin 3 correlated negatively with GFR and positively with inflammatory markers. Patients with protein-energy wasting, inflammation, and cardiovascular disease had higher concentrations of protein pentraxin 3 than their counterparts. Patients with high protein pentraxin 3 levels had higher all-cause and cardiovascular mortality. After adjustment for age, gender, C-reactive protein, and cardiovascular disease, all-cause mortality was still significantly higher in patients with high protein pentraxin 3. Finally, protein pentraxin 3 showed a predictive value of mortality similar to that of IL-6 and better than C-reactive protein.


CONCLUSIONS
Plasma protein pentraxin 3 increases as GFR declines and is associated with the presence of cardiovascular disease and protein-energy wasting. Furthermore, in patients with chronic kidney disease, elevated protein pentraxin 3 predicted all-cause mortality.
Tong
Mengli
M
Division of Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
Carrero
Juan Jesús
JJ
Qureshi
A Rashid
AR
Anderstam
Björn
B
Heimbürger
Olof
O
Bárány
Peter
P
Axelsson
Jonas
J
Alvestrand
Anders
A
Stenvinkel
Peter
P
Lindholm
Bengt
B
Suliman
Mohamed E
ME
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000209:etiology; D002908:Chronic Disease; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000378:metabolism* / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011506:Proteins / Q000378:metabolism*; D000683:Serum Amyloid P-Component / Q000032:analysis*; D000099153:Pentraxins
D002097:C-Reactive Protein; D011506:Proteins; D000683:Serum Amyloid P-Component; D000099153:Pentraxins