title: Kidney function decline in the elderly: impact of lipoprotein-associated phospholipase A(2).
abstract: BACKGROUND
  Whether lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) levels are associated with kidney function decline has not been well studied.
  
  
  METHODS
  We investigated associations of Lp-PLA(2) antigen and activity with kidney function decline and rapid decline over 5.7 years in the Cardiovascular Health Study (n = 4,359). We estimated kidney function by cystatin C (eGFRcys) in repeated measures, and defined rapid decline as ≥3 ml/min/1.73 m(2) per year. We stratified by baseline preserved GFR (≥60 ml/min/1.73 m(2)).
  
  
  RESULTS
  Mean age was 72 ± 5 years. Average eGFRcys decline was -1.79 ml/min/1.73 m(2) (SD = 2.60) per year. Among persons with preserved GFR, compared to the lowest quartile of Lp-PLA(2) antigen, eGFRcys decline was faster among persons in the second, β -0.31 (95% CI -0.52, -0.10), third -0.19 (-0.41, 0.02) and fourth quartiles -0.26 (-0.48, -0.04) after full adjustment. Persons in the highest quartile of Lp-PLA(2) antigen had increased odds of rapid decline 1.34 (1.03, 1.75), compared to the lowest. There was no significant association between levels of Lp-PLA(2) activity and eGFRcys decline or rapid decline. Associations were not statistically significant among persons with low eGFR (<60 ml/min/1.73 m(2)) at baseline.
  
  
  CONCLUSIONS
  Higher levels of Lp-PLA(2) antigen but not activity were significantly associated with faster rates of kidney function decline. These findings may suggest a novel vascular pathway for kidney disease progression.
authors: San Francisco VA Medical Center, Calif., USA. carmenalicia.peralta@ucsf.edu
authors: Carmen A
authors: CA
authors: Peralta
authors: Ronit
authors: R
authors: Katz
authors: Michael
authors: M
authors: Shlipak
authors: Ruth
authors: R
authors: Dubin
authors: Ian
authors: I
authors: DeBoer
authors: Nancy
authors: N
authors: Jenny
authors: Annette
authors: A
authors: Fitzpatrick
authors: Carol
authors: C
authors: Koro
authors: Bryan
authors: B
authors: Kestenbaum
authors: Joachim
authors: J
authors: Ix
authors: Mark
authors: M
authors: Sarnak
authors: Mary
authors: M
authors: Cushman
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000628:therapy; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D005853:Geriatrics / Q000379:methods; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000502:physiology / Q000503:physiopathology*; D007674:Kidney Diseases / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D054467:Phospholipases A2 / Q000378:metabolism*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D055316:Cystatin C; D003404:Creatinine; D054467:Phospholipases A2