title: Inflammation, oxidative stress, glomerular filtration rate, and albuminuria in elderly men: a cross-sectional study.
abstract: BACKGROUND
  The role of inflammation and oxidative stress in mild renal impairment in the elderly is not well studied. Accordingly, we aimed at investigating the associations between estimated glomerular filtration rate (eGFR), albumin/creatinine ratio (ACR), and markers of different inflammatory pathways and oxidative stress in a community based cohort of elderly men.
  
  
  RESULTS
  Cystatin C-based GFR, ACR, and biomarkers of cytokine-mediated inflammation (interleukin-6, high-sensitivity C-reactive protein[CRP], serum amyloid A[SAA]), cyclooxygenase-mediated inflammation (urinary prostaglandin F2α [PGF2α]), and oxidative stress (urinary F2 isoprostanes) were assessed in the Uppsala Longitudinal Study of Adult Men(n = 647, mean age 77 years).
  
  
  RESULTS
  In linear regression models adjusting for age, BMI, smoking, blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides, and treatment with statins, ACE-inhibitors, ASA, and anti-inflammatory agents, eGFR was inversely associated with CRP, interleukin-6, and SAA (β-coefficient -0.13 to -0.19, p < 0.001 for all), and positively associated with urinary F2-isoprostanes (β-coefficient 0.09, p = 0.02). In line with this, ACR was positively associated with CRP, interleukin-6, and SAA (β- coefficient 0.09-0.12, p < 0.02 for all), and negatively associated with urinary F2-isoprostanes (β-coefficient -0.12, p = 0.002). The associations were similar but with lower regression coefficients in a sub-sample with normal eGFR (>60 ml/min/1.73 m2, n = 514), with the exception that F2-isoprostane and SAA were no longer associated with eGFR.
  
  
  CONCLUSIONS
  Our data indicate that cytokine-mediated inflammation is involved in the early stages of impaired kidney function in the elderly, but that cyclooxygenase-mediated inflammation does not play a role at this stage. The unexpected association between higher eGFR/lower albuminuria and increased F2-isoprostanes in urine merits further studies.
authors.affiliation: Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, SE- 751 85, Uppsala, Sweden. ene@du.se
authors.forename: Elisabet
authors.initials: E
authors.lastname: Nerpin
authors.forename: Johanna
authors.initials: J
authors.lastname: Helmersson-Karlqvist
authors.forename: Ulf
authors.initials: U
authors.lastname: Risérus
authors.forename: Johan
authors.initials: J
authors.lastname: Sundström
authors.forename: Anders
authors.initials: A
authors.lastname: Larsson
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Jobs
authors.forename: Samar
authors.initials: S
authors.lastname: Basu
authors.forename: Erik
authors.initials: E
authors.lastname: Ingelsson
authors.forename: Johan
authors.initials: J
authors.lastname: Arnlöv
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood; D005919:Glomerular Filtration Rate; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology*; D018836:Inflammation Mediators / Q000097:blood; D007668:Kidney / Q000503:physiopathology*; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D018384:Oxidative Stress; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology / Q000652:urine; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators; D011451:Prostaglandin-Endoperoxide Synthases