Higher plasma transforming growth factor (TGF)-β is associated with kidney disease in older community dwelling adults.
TGF-β is induced in the vasculature with aging suggesting that high plasma TGF-β levels may be a risk factor for chronic kidney disease (CKD) in older adults.



We conducted a cross-sectional analysis of the association between plasma TGF-β levels and CKD including data for 1722 older adults who had participated in the 1996/97 visit of the Cardiovascular Health Study (CHS). Prevalent CKD was defined as eGFR < 60 mL/min/1.73 m2or urinary albumin/creatinine ratio (ACR) ≥30 mg/g. We also evaluated whether baseline TGF-β levels predicted change in eGFR, cardiovascular (CV) events, or mortality in longitudinal analysis.



Plasma TGF-β levels were significantly and independently associated with lower eGFR in cross-sectional analysis. Doubling of TGF-β was significantly associated with lower eGFR (β estimate after adjusting for CV risk factors = -1.18, 95% CI -2.03, -0.32). We observed no association with albuminuria. There was no association between baseline TGF-β and change in eGFR, but each doubling of TGF-β at baseline was associated with increased risk of a composite outcome of CV events and mortality, adjusted HR 1.10 (95% C.I. 1.02- 1.20, p = 0.006).



In this large cohort of community-dwelling older individuals, high plasma TGF-β levels are modestly, but independently associated with lower eGFR but not with albuminuria in cross-sectional analysis. In addition, TGF-β levels are associated with increased risk of CV events and mortality. Further research is needed to determine the direction of association between plasma TGF-β and the risk of CKD and CKD-associated morbidities in older adults.
University of Colorado Anschutz Medical Center, Aurora, USA.
Tapan
T
Mehta
University of Washington, Seattle, USA.
Petra
P
Buzkova
Albert Einstein College of Medicine, New York, USA.
Jorge R
JR
Kizer
Brigham and Women's Hospital and Harvard Medical School, Boston, USA.
Luc
L
Djousse
University of Colorado Anschutz Medical Center, Aurora, USA.
Michel
M
Chonchol
Beth Israel Deaconess Medical Center, Boston, USA.
Kenneth J
KJ
Mukamal
University of California San Francisco School of Medicine, San Francisco, USA.
Michael
M
Shlipak
University of California, San Diego, USA.
Joachim H
JH
Ix
University of Colorado Anschutz Medical Center, Aurora, USA. diana.jalal@ucdenver.edu.|Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Campus Stop: C281, 12700 E. 19th Ave, Aurora, CO, 80015, USA. diana.jalal@ucdenver.edu.
Diana
D
Jalal
D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D057187:Independent Living; D008297:Male; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000453:epidemiology / Q000652:urine; D016212:Transforming Growth Factor beta / Q000097:blood*; D014481:United States / Q000453:epidemiology
D016212:Transforming Growth Factor beta; D003404:Creatinine
CKD; GFR; Older adults; TGF-β