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Plasma Pentraxin 3 in Patients with Chronic Kidney Disease: Associations with Renal Function, Protein-Energy Wasting, Cardiovascular Disease, and Mortality

Mengli Tong^*,, Juan Jesús Carrero^*,, A. Rashid Qureshi^*,, Björn Anderstam, Olof Heimbürger, Peter Bárány, Jonas Axelsson^*,, Anders Alvestrand, Peter Stenvinkel, Bengt Lindholm^*,, and Mohamed E. Suliman^*,

Divisions of ^* Baxter Novum and Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden; and Division of Renal Medicine, HangZhou Hospital of Traditional Chinese Medicine, HangZhou, China

Address correspondence to: Dr. Mohamed E. Suliman, Divisions of Renal Medicine and Baxter Novum, K56, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. Phone: +46-8-58583982; Fax: +46-8-58583925; E-mail: mohamed.suliman{at}ki.se

Background and Objectives: Plasma protein pentraxin 3 concentrations are elevated in a wide range of diseased states. However, no study has evaluated protein pentraxin 3 in patients with chronic kidney disease.

Design, Setting, Participants, & Measurements: Plasma protein pentraxin 3 concentrations were analyzed in relation to GFR, inflammation, cardiovascular disease, and protein-energy wasting in 71 patients with stages 3 to 4 chronic kidney disease, 276 patients with stage 5 chronic kidney disease, and 61 control subjects. Survival (5 yr) in patients with stage 5 chronic kidney disease was analyzed in relation to protein pentraxin 3 levels.

Results: Both patient groups with chronic kidney disease had higher protein pentraxin 3 concentrations than control subjects, with the highest concentration in patients with stage 5 chronic kidney disease. In all patients with chronic kidney disease, protein pentraxin 3 correlated negatively with GFR and positively with inflammatory markers. Patients with protein-energy wasting, inflammation, and cardiovascular disease had higher concentrations of protein pentraxin 3 than their counterparts. Patients with high protein pentraxin 3 levels had higher all-cause and cardiovascular mortality. After adjustment for age, gender, C-reactive protein, and cardiovascular disease, all-cause mortality was still significantly higher in patients with high protein pentraxin 3. Finally, protein pentraxin 3 showed a predictive value of mortality similar to that of IL-6 and better than C-reactive protein.

Conclusion: Plasma protein pentraxin 3 increases as GFR declines and is associated with the presence of cardiovascular disease and protein-energy wasting. Furthermore, in patients with chronic kidney disease, elevated protein pentraxin 3 predicted all-cause mortality.

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Kamyar Kalantar-Zadeh
Clin. J. Am. Soc. Nephrol. 2007 2: 872-875. [Full Text] [PDF]

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