Article Figures & Data
Figures
- Figure 1.
Flow chart for selection of 402 patients with kidney biopsies.
- Figure 2.
Distributions of urinary fibrinogen-to-creatinine ratios by eGFR and cause of CKD among 402 patients with kidney biopsies. (A) Distributions of urinary fibrinogen-to-creatinine ratios by eGFR. (B) Distributions of urinary fibrinogen-to-creatinine ratios by cause of CKD.
- Figure 3.
Correlations of urinary fibrinogen-to-creatinine ratio with (A) urine protein and (B) eGFR among 402 patients with kidney biopsies.
- Figure 4.
Survival free of ESRD according to urinary fibrinogen-to-creatinine tertile among 402 patients with kidney biopsies. (A) Patients with CKD due to causes other than diabetes (n=301). (B) Patients with CKD due to diabetes (n=101).
Tables
- Table 1.
Baseline characteristics of 402 patients with kidney biopsies stratified by urinary fibrinogen-to-creatinine ratio and 50 healthy control subjects
Variables Healthy Control Subjects, n=50 All Patients with CKD, n=402 Patients with CKD by Urinary Fibrinogen-to-Creatinine Ratio <313 ng/mg, n=134 314–1246 ng/mg, n=134 >1247 ng/mg, n=134 Age, yr 35 (22–45) 41 (31–50) 38 (31–50) 41 (31–50) 46 (36–52) Women, % 46 42 39 43 44 Systolic BP, mmHg 110 (100–122) 130 (120–140) 128 (119–140) 127 (118–140) 135 (125–148) eGFR, ml/min per 1.73 m2 112 (96–128) 82 (53–111) 94 (59–115) 87 (64–114) 75 (39–104) Urine protein, g/24 h — 2.4 (1.0–4.7) 0.9 (0.7–1.6) 2.6 (1.4–4.5) 4.6 (3.3–7.6) Serum albumin, g/dl 4.3 (4.1–4.5) 3.5 (2.6–4.1) 4.0 (3.6–4.4) 3.3 (2.6–3.9) 2.9 (2.3–3.5) Urinary fibrinogen to creatinine, ng/mg 2 (2–3) 536 (191–1461) 131 (52–209) 608 (458–836) 2938 (1683–5782) Disease type, n IgAN — 152 89 45 18 IMN — 94 22 34 38 DN — 101 17 27 57 Focal segmental GN — 55 5 28 22 —, No data; IgAN, IgA nephropathy; IMN, idiopathic membranous nephropathy; DN, diabetic nephropathy.
- Table 2.
Comparison of baseline characteristics of 402 patients with kidney biopsies by development of ESRD during follow-up
Variables Non-ESRD, n=334 ESRD, n=68 P Value Age, yr 41 (31–50) 43(31–51) 0.51 Women, % 44 34 0.13 Follow-up, mo 35.8 (24.5–83.1) 42.8 (27.1–63.8) 0.94 eGFR ml/min per 1.73 m2 91 (61–113) 57 (34–83) <0.001 Systolic BP, mmHg 129 (120–140) 140 (125–150) 0.11 Urine protein, g/24 h 1.9 (1.0–4.4) 3.7 (2.4–5.6) <0.001 Serum albumin, g/dl 3.5 (2.6–4.1) 3.6 (2.7–3.9) 0.91 Urinary fibrinogen to Cr, ng/mg 521.1 (177.5–1451.3) 1599.9 (654.9–4148.6) <0.001 Global sclerosis, % 8 (0–27) 17 (33–58) <0.001 Segmental sclerosis, % 0 (0–7) 3 (0–14) 0.01 IFTA 1 (1–2) 2 (1–2) <0.001 Disease type, n (%) <0.001 IgAN 130 (39) 22 (32) IMN 89 (27) 5 (7) DN 64 (19) 37 (54) Focal segmental GN 51 (15) 4 (6) Cr, creatinine; IFTA, interstitial fibrosis and tubular atrophy; IgAN, IgA nephropathy; IMN, idiopathic membranous nephropathy; DN, diabetic nephropathy.
- Table 3.
Cox regression analysis for incident ESRD according to baseline variables among 402 patients with kidney biopsies
Variables Univariable Multivariable HR (95% CI) P Value HR (95% CI) P Value Age, yr 1.01 (0.99 to 1.03) 0.23 Sex 1.50 (0.91 to 2.48) 0.12 Systolic BP, >140 mmHg 1.03 (1.02 to 1.04) <0.001 1.00 (0.99 to 1.02) 0.68 eGFR, ≥15 ml/min per 1.73 m2 0.96 (0.95 to 0.97) <0.001 0.98 (0.97 to 0.99) <0.001 Disease type <0.001 <0.001 IgAN 1.0 (Reference) 1.0 (Reference) IMN 0.54 (0.13 to 0.98) 0.001 0.15 (0.03 to 0.70) 0.02 DN 3.61 (1.75 to 5.42) 0.001 3.13 (1.59 to 6.18) 0.001 Focal segmental GN 3.32 (1.26 to 10.23) 0.02 2.10 (0.56 to 7.85) 0.27 Serum albumin, g/dl 1.02 (0.99 to 1.05) 0.16 Log10 urine protein 3.36 (1.83 to 6.12) <0.001 2.63 (1.36 to 6.45) 0.002 Log10 urinary fibrinogen to Cr 2.72 (1.91 to 3.87) <0.001 2.12 (1.31 to 3.26) 0.003 IFTA 3.41 (2.47 to 4.72) <0.001 1.76 (1.22 to 2.52) 0.002 Global sclerosis 1.19 (1.00 to 1.43) 0.06 Segmental sclerosis 1.10 (0.55 to 2.20) 0.80 HR, hazard ratio; 95% CI, 95% confidence interval; IgAN, IgA nephropathy; IMN, idiopathic membranous nephropathy; DN, diabetic nephropathy; Cr, creatinine; IFTA, interstitial fibrosis and tubular atrophy.
Variables All Patients with CKD, n=402 Subgroup with CKD Due to Cause Other Than Diabetes, n=301 Subgroup with CKD Due to Diabetes, n=101 Model 1 Model 1 + Log10 (Urinary Fibrinogen to Cr) Model 1 Model 1 + Log10 (Urinary Fibrinogen to Cr) Model 1 Model 1 + Log10 (Urinary Fibrinogen to Cr) AUC 0.73 0.76 0.84 0.85 0.71 0.74 LR test 0.003a 0.07a 0.02a AIC 333.6 326.9b 141.1 139.9 133.9 130.6b IDI 0.02 (95% CI, 0.01 to 0.04); P<0.01a 0.01 (95% CI, <−0.01 to 0.01); P=0.20a 0.05 (95% CI, <0.01 to 0.09); P=0.04a NRI 0.43 (95% CI, 0.17 to 0.69); P=0.001a 0.13 (95% CI, −0.27 to 0.53); P=0.34a 0.48 (95% CI, 0.07 to 0.88); P=0.02a Model 1 included eGFR, urine protein, and BP (adjusted for age and sex); model 2 included panel + log10 (urinary fibrinogen to Cr). Cr, creatinine; AUC, area under the curve; LR, likelihood ratio; AIC, Akaike information criterion; IDI, integrated discrimination improvement; 95% CI, confidence interval; NRI, net reclassification improvement.
↵a P value (model 1 versus model 2).
↵b Significant between models 1 and 2.
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Keywords
- chronic kidney disease
- fibrinogen
- predictor
- progression
- Glomerulonephritis, IGA
- Podocytes
- Glomerulonephritis, Membranous
- risk factors
- diabetic nephropathies
- creatinine
- blood pressure
- Glomerulosclerosis, Focal Segmental
- glomerular filtration rate
- Confidence Intervals
- renal insufficiency, chronic
- Blood Pressure Determination
- Disease Progression
- Kidney Failure, Chronic