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Biomarkers associated with worsening renal function and progression in chronic kidney disease among patients hospitalized for acute heart failure

Ohlsson, Marcus Andreas LU orcid ; Molvin, John LU ; Holm Isholth, Hannes LU ; Nezami, Zainu LU ; Laucyte-Cibulskiene, Agne LU orcid ; Christensson, Anders LU ; Jujic, Amra LU orcid and Magnusson, Martin LU orcid (2025) In CardioRenal Medicine p.1-13
Abstract

INTRODUCTION: Worsening renal function (WRF) is associated with poor prognosis in patients with heart failure (HF). Osteopontin (OPN) and Matrix extracellular phosphoglycoprotein (MEPE) are expressed in the kidneys and are involved in bone mineralization processes. Higher OPN levels have been associated with a higher risk for adverse outcomes in patients with chronic kidney disease (CKD), and MEPE has been shown to promote renal phosphate excretion. Here, we explored if MEPE and OPN are associated with WRF and CKD in patients admitted for acute HF.

METHODS: WRF was defined as an increase in plasma creatinine of >26.5 mmol/L or 50% higher than admission concentration within 48 hours of admission. OPN and MEPE were analyzed in... (More)

INTRODUCTION: Worsening renal function (WRF) is associated with poor prognosis in patients with heart failure (HF). Osteopontin (OPN) and Matrix extracellular phosphoglycoprotein (MEPE) are expressed in the kidneys and are involved in bone mineralization processes. Higher OPN levels have been associated with a higher risk for adverse outcomes in patients with chronic kidney disease (CKD), and MEPE has been shown to promote renal phosphate excretion. Here, we explored if MEPE and OPN are associated with WRF and CKD in patients admitted for acute HF.

METHODS: WRF was defined as an increase in plasma creatinine of >26.5 mmol/L or 50% higher than admission concentration within 48 hours of admission. OPN and MEPE were analyzed in 315 HF patients at baseline, and in 120 patients at 6-month follow-up. Associations between MEPE and OPN, and a) WRF, b) CKD stage 3-5, and c) markers of kidney function were explored. Further, OPN and MEPE at baseline and at 6 month follow-up (delta (Δ) values) were related to CKD progression.

RESULTS: The study population had a mean age of 75 (±12) years and 31% were women. Higher levels of MEPE and OPN were associated with WRF (n=30; OR 2.80 (1.49-5.25); p=0.001, and OR 1.84; (1.05-3.23); p=0.034, respectively)). On admission, both MEPE and OPN were associated with CKD stage 3-5 (OR 5.27; (2.76-10.07); p<0.001, and OR 3.26; (1.90-5.60); p<0.001, respectively)). At 6-month follow-up, progression in CKD stage was associated with ΔMEPE and ΔOPN (HR 2.53; (1.48-4.31); p<0.001, and HR 2.66; (1.51-4.71); p<0.001)).

CONCLUSION: Here, MEPE and OPN are for the first time shown to be independently associated with WRF and subsequent deterioration in CKD in a HF cohort. The mechanisms of these associations are currently largely unknown and need to be investigated further.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
CardioRenal Medicine
pages
1 - 13
publisher
Karger
external identifiers
  • pmid:40334655
ISSN
1664-5502
DOI
10.1159/000546236
language
English
LU publication?
yes
additional info
The Author(s). Published by S. Karger AG, Basel.
id
ffef3daa-c1b9-4127-a26f-8a9949c8438d
date added to LUP
2025-05-12 10:21:31
date last changed
2025-05-12 10:35:10
@article{ffef3daa-c1b9-4127-a26f-8a9949c8438d,
  abstract     = {{<p>INTRODUCTION: Worsening renal function (WRF) is associated with poor prognosis in patients with heart failure (HF). Osteopontin (OPN) and Matrix extracellular phosphoglycoprotein (MEPE) are expressed in the kidneys and are involved in bone mineralization processes. Higher OPN levels have been associated with a higher risk for adverse outcomes in patients with chronic kidney disease (CKD), and MEPE has been shown to promote renal phosphate excretion. Here, we explored if MEPE and OPN are associated with WRF and CKD in patients admitted for acute HF.</p><p>METHODS: WRF was defined as an increase in plasma creatinine of &gt;26.5 mmol/L or 50% higher than admission concentration within 48 hours of admission. OPN and MEPE were analyzed in 315 HF patients at baseline, and in 120 patients at 6-month follow-up. Associations between MEPE and OPN, and a) WRF, b) CKD stage 3-5, and c) markers of kidney function were explored. Further, OPN and MEPE at baseline and at 6 month follow-up (delta (Δ) values) were related to CKD progression.</p><p>RESULTS: The study population had a mean age of 75 (±12) years and 31% were women. Higher levels of MEPE and OPN were associated with WRF (n=30; OR 2.80 (1.49-5.25); p=0.001, and OR 1.84; (1.05-3.23); p=0.034, respectively)). On admission, both MEPE and OPN were associated with CKD stage 3-5 (OR 5.27; (2.76-10.07); p&lt;0.001, and OR 3.26; (1.90-5.60); p&lt;0.001, respectively)). At 6-month follow-up, progression in CKD stage was associated with ΔMEPE and ΔOPN (HR 2.53; (1.48-4.31); p&lt;0.001, and HR 2.66; (1.51-4.71); p&lt;0.001)).</p><p>CONCLUSION: Here, MEPE and OPN are for the first time shown to be independently associated with WRF and subsequent deterioration in CKD in a HF cohort. The mechanisms of these associations are currently largely unknown and need to be investigated further.</p>}},
  author       = {{Ohlsson, Marcus Andreas and Molvin, John and Holm Isholth, Hannes and Nezami, Zainu and Laucyte-Cibulskiene, Agne and Christensson, Anders and Jujic, Amra and Magnusson, Martin}},
  issn         = {{1664-5502}},
  language     = {{eng}},
  month        = {{05}},
  pages        = {{1--13}},
  publisher    = {{Karger}},
  series       = {{CardioRenal Medicine}},
  title        = {{Biomarkers associated with worsening renal function and progression in chronic kidney disease among patients hospitalized for acute heart failure}},
  url          = {{http://dx.doi.org/10.1159/000546236}},
  doi          = {{10.1159/000546236}},
  year         = {{2025}},
}