TY - JOUR
T1 - Proenkephalin A 119-159 (penKid) and mortality in stable patients at high cardiovascular risk
AU - Rau, Matthias
AU - Kurt, Berkan
AU - Hartmann, Oliver
AU - Lobo de Sá, Fábia Daniela
AU - Schwarz, Marvin
AU - Thiele, Kirsten
AU - Hartmann, Niels-Ulrik Korbinian
AU - Spiesshoefer, Jens
AU - Möllmann, Julia
AU - Hohl, Mathias
AU - Selejan, Simina-Ramona
AU - van der Vorst, Emiel P C
AU - Dahl, Edgar
AU - Marx, Nikolaus
AU - Kahles, Florian
AU - Lehrke, Michael
N1 - nicht zu werten, Kreisklinik BR ist nicht genannt
PY - 2024/9
Y1 - 2024/9
N2 - BACKGROUND: Proenkephalin A 119-159 (penKid) is a novel blood biomarker for real-time assessment of kidney function and was found to be independently associated with worsening kidney function and mortality. A novel penKid-based estimated glomerular filtration rate equation (eGFRPENK-Crea), outperforms current creatinine-based eGFR equations in predicting iohexol or iothalamate plasma clearance-based measured GFR. In this study, we aimed to evaluate the predictive value of penKid and eGFRPENK-Crea for all-cause mortality in stable patients at high cardiovascular risk.METHODS: Circulating penKid levels were assessed in 615 stable patients hospitalized at the Department of Cardiology at University Hospital Aachen, Germany. The endpoint was all-cause mortality; follow up was 3 years.RESULTS: penKid levels were higher in 46 non-survivors [58.8 (IQR 47.5-85.0) pmol/l] compared to 569 survivors [43.8 (IQR 34.0-58.0) pmol/l; P < .0001]. Univariable Cox regression analyses found penKid and eGFRPENK-Crea to be associated with all-cause mortality (C index 0.703, χ 2 33.27, P < .00001; C index 0.716, χ 2 36.51, P < .00001). This association remained significant after adjustment for significant baseline parameters including age, smoking, chronic heart failure, use of diuretics, leucocytes, body mass index, sex, and creatinine (C index 0.799, χ 2 72.06, P < .00001). Importantly, penKid provided significant added value on top of eGFRCKD-EPI 2021 (eGFRCKD-EPI 2021: C index 0.716, χ 2 34.21; eGFRCKD-EPI 2021 + penKid: C index 0.727, χ 2: 40.02; Delta χ 2 5.81; all P < .00001) for all-cause mortality prediction in our cohort.CONCLUSIONS: penKid levels and eGFRPENK-Crea is associated with all-cause mortality within a 3-year follow-up period and the addition of penKid on top of eGFRCKD-EPI 2021 provided significant added value in mortality prediction.
AB - BACKGROUND: Proenkephalin A 119-159 (penKid) is a novel blood biomarker for real-time assessment of kidney function and was found to be independently associated with worsening kidney function and mortality. A novel penKid-based estimated glomerular filtration rate equation (eGFRPENK-Crea), outperforms current creatinine-based eGFR equations in predicting iohexol or iothalamate plasma clearance-based measured GFR. In this study, we aimed to evaluate the predictive value of penKid and eGFRPENK-Crea for all-cause mortality in stable patients at high cardiovascular risk.METHODS: Circulating penKid levels were assessed in 615 stable patients hospitalized at the Department of Cardiology at University Hospital Aachen, Germany. The endpoint was all-cause mortality; follow up was 3 years.RESULTS: penKid levels were higher in 46 non-survivors [58.8 (IQR 47.5-85.0) pmol/l] compared to 569 survivors [43.8 (IQR 34.0-58.0) pmol/l; P < .0001]. Univariable Cox regression analyses found penKid and eGFRPENK-Crea to be associated with all-cause mortality (C index 0.703, χ 2 33.27, P < .00001; C index 0.716, χ 2 36.51, P < .00001). This association remained significant after adjustment for significant baseline parameters including age, smoking, chronic heart failure, use of diuretics, leucocytes, body mass index, sex, and creatinine (C index 0.799, χ 2 72.06, P < .00001). Importantly, penKid provided significant added value on top of eGFRCKD-EPI 2021 (eGFRCKD-EPI 2021: C index 0.716, χ 2 34.21; eGFRCKD-EPI 2021 + penKid: C index 0.727, χ 2: 40.02; Delta χ 2 5.81; all P < .00001) for all-cause mortality prediction in our cohort.CONCLUSIONS: penKid levels and eGFRPENK-Crea is associated with all-cause mortality within a 3-year follow-up period and the addition of penKid on top of eGFRCKD-EPI 2021 provided significant added value in mortality prediction.
U2 - 10.1093/ckj/sfae246
DO - 10.1093/ckj/sfae246
M3 - Original Article
C2 - 39790480
SN - 2048-8505
VL - 17
SP - fae246
JO - CLINICAL KIDNEY JOURNAL
JF - CLINICAL KIDNEY JOURNAL
IS - 9
ER -