title: Novel biomarkers do not correlate with severity of vascular stiffness in CKD patients with severe co-morbid disease.
abstract: OBJECTIVE
  Novel biomarkers may help explain the pathobiology of vascular disease in chronic kidney disease, and thus set the stage for identification of therapeutic targets, potential reversibility, and improved outcomes in this population.
  
  
  METHODS
  124 subjects with GFR <60 ml/min or on renal replacement therapy underwent measurement of inflammatory, vascular and cardiac biomarkers as well as aortic pulse wave velocity (PWV) testing. A subset of patients (n = 60) had repeat PWV measured at 6 months.
  
  
  RESULTS
  Thirty-four percent of the patients were diabetic, and 50% had a history of cardiovascular disease or congestive heart failure. Median PWV was 9.8 (IQR 8.3-12.7) m/s. No significant correlations between the measured biomarkers and baseline PWV was observed. An increase in PWV (>1.5 m/s) over 6 months was observed in those subjects with diabetes, a higher brain natriuretic peptide level, lower cholesterol and lower phosphate level. Age (HR 1.086, p = 0.0028), fetuin (0.024, p = 0.0448), and interleukin-10 (top tertile HR 4.720, p = 0.0359) were associated with mortality.
  
  
  CONCLUSIONS
  In this cohort of patients with chronic kidney disease and diabetes and/or heart disease, we were unable to demonstrate that select biomarkers can inform processes leading to vascular disease. Biomarkers do appear to have utility in predicting future events in this population.
authors.affiliation: Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, B.C., Canada. CCherneski@providencehealth.bc.ca
authors.forename: Catherine
authors.initials: C
authors.lastname: Weber
authors.forename: Mhairi
authors.initials: M
authors.lastname: Sigrist
authors.forename: Alexandra
authors.initials: A
authors.lastname: Romann
authors.forename: Giusy
authors.initials: G
authors.lastname: Chiarelli
authors.forename: Adeera
authors.initials: A
authors.lastname: Levin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000503:physiopathology*; D015415:Biomarkers; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology* / Q000503:physiopathology; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010710:Phosphates / Q000097:blood; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011673:Pulsatile Flow; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000401:mortality* / Q000503:physiopathology; D012720:Severity of Illness Index; D059289:Vascular Stiffness; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism
chemical_list: D015415:Biomarkers; D010710:Phosphates; D060749:alpha-2-HS-Glycoprotein; D020097:Natriuretic Peptide, Brain; D016753:Interleukin-10; D002784:Cholesterol