Chronic Kidney Diseases, Heart Failure
Conditions
Brief summary
The individual course of chronic kidney disease (CKD) may vary, and improved methods for identifying which patients will experience estimated glomerular filtration rate (eGFR) decline are needed. Recently, urinary dickkopf-3 (DKK3) has been proposed to predict eGFR decline in patients with CKD, independent of presence of albuminuria. The investigators sought to examine the association between changes in DKK3 levels and eGFR decline in patients with heart failure (HF).
Detailed description
The individual course of chronic kidney disease (CKD) may vary, and improved methods for identifying which patients will experience estimated glomerular filtration rate (eGFR) decline are needed. Recently, urinary dickkopf-3 (DKK3) has been identified as an stress-induced, renal tubular epithelia-derived, secreted glycoprotein that induces tubulointerstitial fibrosis. Urinary DKK3 has been found to predict eGFR decline in patients with CKD, independent of presence of albuminuria, but its association with eGFR decline in patients with heart failure (HF) is unknown. The investigators sought to examine the association between changes in DKK3 and eGFR decline in patients with HF.
Interventions
DIAGNOSTIC_TESTNo intervention
No intervention
Sponsors
University of Giessen
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Outpatients ≥18 years of age with diagnosed HF or diabetes or hypertension
Exclusion criteria
* CKD with estimated GFR \<20 ml/min/1.73 m2 (2012 CKD-EPI equation) * CKD with extracorporeal or peritoneal ultrafiltration due to diuretic-resistant fluid overload * active tumor disease * inflammatory or autoimmune disease requiring systemic immunosuppressive treatment * clinically apparent infections * recipients of solid-organ transplants * anticipated life expectancy of \<12 months * likelihood of receiving advanced therapy (mechanical circulatory assist device/cardiac transplant) * pregnancy or possibility of pregnancy in the next 12 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Association between DKK3 and eGFR decline | 24 months | DKK3 and eGFR (CKD-Epidemiology Collaboration equation) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Association of right and left ventricular function with DKK3 | 24 months | Echocardiography |
| Association between proteinuria and DKK3 | 24 months | DKK3 and proteinuria, albuminuria, and alpha 1 microglobulin excretion |
| Persistent or worsening of HF | 24 months | Cardiovascular death, hospital admission for decompensated HF, or clinical HF decompensation without hospital admission (but requiring parenteral HF therapy or changes in oral HF medications including diuretics) |
| Need for renal replacement therapy | 24 months | Requirement of incident renal replacement therapy |
| Association of venous congestion/volume overload with DKK3 | 24 months | B-type natriuretic peptide, clinical examination, bioimpedance analysis, echocardiography |
Countries
Germany
Outcome results
None listed