title: von Willebrand Factor, ADAMTS13 Activity, and Decline in Kidney Function: A Population-Based Cohort Study.
abstract: BACKGROUND
  Altered levels of von Willebrand factor (vWF) and ADAMTS13 can promote thrombosis and disturb blood flow in kidney microcirculations. We investigated the association of serum vWF:ADAMTS13 ratio in relation to decline in kidney function.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  2,479 individuals (mean age, 65.1±5.9 [SD] years; 43% men) from the population-based Rotterdam Study.
  
  
  METHODS
  vWF, ADAMTS13, and vWF:ADAMTS13 ratio.
  
  
  METHODS
  Annual decline in estimated glomerular filtration rate (eGFR), halving of eGFR, and new-onset eGFR<60mL/min/1.73m2were assessed.
  
  
  RESULTS
  During a median follow-up of 11 (range, 7.81-13.57) years, 500 cases of new-onset eGFR<60mL/min/1.73m2occurred. The population had a mean eGFR decline of 0.96±0.92mL/min/1.73m2per year. Higher vWF:ADAMTS13 ratio was associated with steeper annual decline in eGFR (difference, -0.06 [95% CI, -0.09 to -0.02] mL/min/1.73m2per year) and higher risk for new-onset eGFR<60mL/min/1.73m2(OR, 1.13; 95% CI, 1.01-1.27). Likewise, higher vWF:ADAMTS13 ratio was associated with higher risk for halving of eGFR (OR, 1.40; 95% CI, 1.02-1.93). After adjustment for cardiovascular risk factors and blood group, effect estimates remained the same.
  
  
  CONCLUSIONS
  No data available for albuminuria. Participants were classified based on a single measurement of vWF and ADAMTS13.
  
  
  CONCLUSIONS
  In this population-based study, we showed that higher vWF:ADAMTS13 ratio is associated with decline in kidney function, suggesting a role of elevated prothrombotic factors in the development and progression of kidney disease.
authors: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: Sanaz
authors: S
authors: Sedaghat
authors: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: Paul S
authors: PS
authors: de Vries
authors: Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: Johan
authors: J
authors: Boender
authors: Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: Michelle A H
authors: MA
authors: Sonneveld
authors: Department of Internal Medicine-Nephrology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: Ewout J
authors: EJ
authors: Hoorn
authors: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: Albert
authors: A
authors: Hofman
authors: Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: Moniek P M
authors: MP
authors: de Maat
authors: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: Oscar H
authors: OH
authors: Franco
authors: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: M Arfan
authors: MA
authors: Ikram
authors: Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: Frank W G
authors: FW
authors: Leebeek
authors: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: a.dehghan@erasmusmc.nl.
authors: Abbas
authors: A
authors: Dehghan
mesh_terms: D000071120:ADAMTS13 Protein / Q000097:blood* / Q000502:physiology*; D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014841:von Willebrand Factor / Q000032:analysis*
chemical_list: D014841:von Willebrand Factor; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human
keywords: ADAMTS13 activity; disease progression; eGFR trajectory; estimated glomerular filtration rate (eGFR); kidney disease; prothrombotic factors; von Willebrand factor (vWF); von Willebrand factor protease