دورية أكاديمية
أعرض في EDS

Assessment of Proximal Tubular Function by Tubular Maximum Phosphate Reabsorption Capacity in Heart Failure.

التفاصيل البيبلوغرافية
العنوان: Assessment of Proximal Tubular Function by Tubular Maximum Phosphate Reabsorption Capacity in Heart Failure.
المؤلفون: Emmens JE; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., de Borst MH; Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Boorsma EM; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Damman K; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Navis G; Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van Veldhuisen DJ; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Dickstein K; Department of Clinical Sciences, University of Bergen, Bergen, Norway.; Stavanger University Hospital, Stavanger, Norway., Anker SD; Department of Cardiology and Berlin-Brandenburg Center for Regenerative Therapies, German Centre for Cardiovascular Research Partner Site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany.; Department of Cardiology and Pneumology, University Medical Center Goettingen, Goettingen, Germany., Lang CC; School of Medicine Centre for Cardiovascular and Lung Biology, Division of Molecular and Clinical Medicine, University of Dundee, Dundee, United Kingdom., Filippatos G; Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece., Metra M; Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy., Samani NJ; Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.; National Institute for Health Research, Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom., Ponikowski P; Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.; Cardiology Department, Military Hospital, Wroclaw, Poland., Ng LL; Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.; National Institute for Health Research, Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom., Voors AA; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Ter Maaten JM; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
المصدر: Clinical journal of the American Society of Nephrology : CJASN [Clin J Am Soc Nephrol] 2022 Feb; Vol. 17 (2), pp. 228-239.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101271570 Publication Model: Print Cited Medium: Internet ISSN: 1555-905X (Electronic) Linking ISSN: 15559041 NLM ISO Abbreviation: Clin J Am Soc Nephrol Subsets: MEDLINE
أسماء مطبوعة: Publication: 2023- : Hagerstown, MD : Wolters Kluwer Health
Original Publication: Washington, D.C. : American Society of Nephrology, c2005-
مواضيع طبية MeSH: Renal Reabsorption*, Heart Failure/*metabolism , Kidney Tubules, Proximal/*metabolism , Phosphates/*metabolism, Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged
مستخلص: Background and Objectives: The estimated glomerular filtration rate (eGFR) is a crucial parameter in heart failure. Much less is known about the importance of tubular function. We addressed the effect of tubular maximum phosphate reabsorption capacity (TmP/GFR), a parameter of proximal tubular function, in patients with heart failure.
Design, Setting, Participants, & Measurements: We established TmP/GFR (Bijvoet formula) in 2085 patients with heart failure and studied its association with deterioration of kidney function (>25% eGFR decrease from baseline) and plasma neutrophil gelatinase-associated lipocalin (NGAL) doubling (baseline to 9 months) using logistic regression analysis and clinical outcomes using Cox proportional hazards regression. Additionally, we evaluated the effect of sodium-glucose transport protein 2 (SGLT2) inhibition by empagliflozin on tubular maximum phosphate reabsorption capacity in 78 patients with acute heart failure using analysis of covariance.
Results: Low TmP/GFR (<0.80 mmol/L) was observed in 1392 (67%) and 21 (27%) patients. Patients with lower TmP/GFR had more advanced heart failure, lower eGFR, and higher levels of tubular damage markers. The main determinant of lower TmP/GFR was higher fractional excretion of urea ( P <0.001). Lower TmP/GFR was independently associated with higher risk of plasma NGAL doubling (odds ratio, 2.20; 95% confidence interval, 1.05 to 4.66; P =0.04) but not with deterioration of kidney function. Lower TmP/GFR was associated with higher risk of all-cause mortality (hazard ratio, 2.80; 95% confidence interval, 1.37 to 5.73; P =0.005), heart failure hospitalization (hazard ratio, 2.29; 95% confidence interval, 1.08 to 4.88; P =0.03), and their combination (hazard ratio, 1.89; 95% confidence interval, 1.07 to 3.36; P =0.03) after multivariable adjustment. Empagliflozin significantly increased TmP/GFR compared with placebo after 1 day ( P =0.004) but not after adjustment for eGFR change.
Conclusions: TmP/GFR, a measure of proximal tubular function, is frequently reduced in heart failure, especially in patients with more advanced heart failure. Lower TmP/GFR is furthermore associated with future risk of plasma NGAL doubling and worse clinical outcomes, independent of glomerular function.
(Copyright © 2022 by the American Society of Nephrology.)
التعليقات: Comment in: Clin J Am Soc Nephrol. 2022 Feb;17(2):182-183. (PMID: 35131926)
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فهرسة مساهمة: Keywords: heart failure; outcomes; proximal tubule; renal dysfunction
المشرفين على المادة: 0 (Phosphates)
تواريخ الأحداث: Date Created: 20220208 Date Completed: 20220317 Latest Revision: 20230421
رمز التحديث: 20230422
مُعرف محوري في PubMed: PMC8823926
DOI: 10.2215/CJN.03720321
PMID: 35131929
قاعدة البيانات: MEDLINE
الوصف
تدمد:1555-905X
DOI:10.2215/CJN.03720321