Cardiovascular and Renal Outcome in CKD 2-4 Patients - The Fourth Homburg evaluation

Inclusion Criteria:

Chronic kidney disease KDOQI 2-4

Exclusion Criteria:

Systemic immunosuppressive medication
Acute infectious disease
Active malignant disease
Acute renal injury

Baseline Parameters:

Traditional cardiovascular risk factors
Parameters of calcium-phosphate metabolism
Echocardiography (analysed in ~400 participants)
Ultrasound renal and splenic resistive indices
Cell counts of monocyte subsets

Number of Participants:

444 Participants scheduled to be included (recruitment ongoing)

Combined primary cardiovascular outcome:

Any cardiovascular event (acute myocardial infarction; surgical or interventional coronary / cerebrovascular / peripheral-arterial revascularization; stroke [symptoms ≥ 24 hours]; amputation above the ankle; death)

Combined primary renal outcome:

Reduction of eGFR ≤50% baseline, ESRD (renal replacement therapy for ≥ 3 months), death

Secondary cardiovascular outcome:

Acute myocardial infarction, ischemic stroke (symptoms ≥ 24 hours), cardiovascular death

Secondary renal outcome:

Reduction of eGFR ≤50% baseline, ESRD (renal replacement therapy for ≥ 3 months)

Publications:

Untersteller K, Girerd N, Duarte K, Rogacev KS, Seiler-Mussler S, Fliser D, Rossignol P, Heine GH.

NT-proBNP and Echocardiographic Parameters for Prediction of Cardiovascular Outcomes in Patients with CKD Stages G2-G4.

Clin J Am Soc Nephrol. 2016. Abstract

Bauer L, Emrich IE, Pickering JW, Untersteller K, Sandermann F, Rogacev KS, Seiler-Mussler S, Fliser D, Heine GH.

Best Albuminuria Measurement to Predict Cardiovascular and Renal Events.

Am J Nephrol. 2016;43(5):383-388. Abstract

Rogacev KS, Heine GH, Silbernagel G, Kleber ME, Seiler S, Emrich I, Lennartz S, Werner C, Zawada AM, Fliser D, Bohm M, Marz W, Scharnagl H, Laufs U.

PCSK9 Plasma Concentrations Are Independent of GFR and Do Not Predict Cardiovascular Events in Patients with Decreased GFR.

PLoS One. 2016;11(1):e0146920. Abstract

Lennartz CS, Pickering JW, Seiler-Mussler S, Bauer L, Untersteller K, Emrich IE, Zawada AM, Radermacher J, Tangri N, Fliser D, Heine GH.

External Validation of the Kidney Failure Risk Equation and Re-Calibration with Addition of Ultrasound Parameters.

Clin J Am Soc Nephrol. 2016;11(4):609-615. Abstract

Zawada AM¹, Fell LH¹, Untersteller K, Seiler S, Rogacev KS, Fliser D, Ziegler-Heitbrock L, Heine GH.

Comparison of two different strategies for human monocyte subsets gating within the large-scale prospective CARE FOR HOMe Study.

Cytometry A 2015 Aug;87(8):750-8. Abstract

Bolignano D¹, Lennartz S¹, Leonardis D, D'Arrigo G, Tripepi R, Emrich IE, Mallamaci F, Fliser D, Heine G, Zoccali C.

High estimated pulmonary artery systolic pressure predicts adverse cardiovascular outcomes in stage 2-4 chronic kidney disease.

Kidney Int 2015 Jul;88(1):130-6. Abstract

Rambod M, Heine GH, Seiler S, Dominic EA, Rogacev KS, Dwivedi R, Ramezani A, Wing MR, Amdur RL, Fliser D, Raj DS.

Association of vascular endothelial factors with cardiovascular outcome and mortality in chronic kidney disease patients: A 4-year cohort study.

Atherosclerosis 2014 Oct;236(2):360-5. Abstract

Rogacev KS, Zawada AM, Emrich I, Seiler S, Bohm M, Fliser D, Woollard KJ, Heine GH.

Lower Apo A-I and Lower HDL-C Levels Are Associated With Higher Intermediate CD14++CD16+ Monocyte Counts That Predict Cardiovascular Events in CKD.

Arterioscler Thromb Vasc Biol 2014 Jul 24. Abstract

Seiler S, Rogacev KS, Roth HJ, Shafein P, Emrich I, Neuhaus S, Floege J, Fliser D, Heine GH.

Associations of FGF-23 and sKlotho with Cardiovascular Outcomes among Patients with CKD Stages 2-4.

Clin J Am Soc Nephrol 2014 Mar 27. Abstract

Rogacev KS, Pickering JW, Seiler S, Zawada AM, Emrich I, Fliser D, Heine GH.

The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation incorporating both cystatin C and creatinine best predicts individual risk: a cohort study in 444 patients with chronic kidney disease.

Nephrol Dial Transplant 2014 Feb;29(2):348-55. Abstract

Grün OS, Herath E, Weihrauch A, Flügge F, Rogacev KS, Fliser D, Heine GH.

Does the Measurement of the Difference of Resistive Indexes in Spleen and Kidney Allow a Selective Assessment of Chronic Kidney Injury?

Radiology 2012 Sep;264(3):894-902. Abstract

Seiler S, Wen M, Roth HJ, Fehrenz M, Flugge F, Herath E, Weihrauch A, Fliser D, Heine GH.

Plasma Klotho is not related to kidney function and does not predict adverse outcome in patients with chronic kidney disease.

Kidney Int 2013 Jan;83(1):121-8. Abstract

Medical Theses:

Franziska Flügge
Adiponektin-Subfraktionen und kardiovaskuläre Morbidität bei Patienten mit chronischer Nierenerkrankung

Esther Herath
Ermöglicht die gleichzeitige Bestimmung renaler und lienaler Widerstandsindices eine selektive Beurteilung der chronischen Nierenschädigung?

Anja Weihrauch
Sind renale Widerstandsindices nierenspezifische Ultraschallparameter?– Detektion der linksventrikulären diastolischen Dysfunktion als weiteren extrarenalen Einflussfaktor

Insa Emrich

S-Adenosylhomocystein (SAH)- Ein neuer nicht-traditioneller kardiovaskulärer Risikofaktor bei chronischer Nierenerkrankung?

Michael Fehrenz

Fibroblast Growth Factor 23 surpasses soluble Klotho as renal predictor in chronic kidney disease

Pagah Shafein / Simone Lennartz / Kathrin Untersteller (ongoing)

Franziska Sandermann / Marc Baier (ongoing)