High C-reactive protein levels increase risk for chronic kidney disease hospitalisations in adults of a remote Indigenous Australian community - A prospective cohort study

Arnold, Luke W., Hoy, Wendy E. and Wang, Zhiqiang (2017) High C-reactive protein levels increase risk for chronic kidney disease hospitalisations in adults of a remote Indigenous Australian community - A prospective cohort study. Nephrology, 22 9: 699-705. doi:10.1111/nep.12841


Author Arnold, Luke W.
Hoy, Wendy E.
Wang, Zhiqiang
Title High C-reactive protein levels increase risk for chronic kidney disease hospitalisations in adults of a remote Indigenous Australian community - A prospective cohort study
Journal name Nephrology   Check publisher's open access policy
ISSN 1320-5358
1440-1797
Publication date 2017-09-01
Year available 2016
Sub-type Article (original research)
DOI 10.1111/nep.12841
Open Access Status Not yet assessed
Volume 22
Issue 9
Start page 699
End page 705
Total pages 7
Place of publication Richmond, Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Formatted abstract
Background
Indigenous Australians are significantly burdened by chronic kidney disease (CKD). Elevated levels of C-reactive protein (CRP) have been associated with diabetes and cardiovascular incidence in previous studies. Elevated CRP has been associated with albuminuria and reduced eGFR in cross-section, this study investigated the long term predictive association between CRP measured at a baseline exam and the incidence of a CKD-related hospitalisation.

Methods

Health screening examinations were conducted for individuals of a remote indigenous Australian community between 1992 and 1998. Using Northern Territory hospital records up to 2010, Cox proportional hazard models estimated the risk of CKD hospitalisations.

Results
546 participants were included in the analysis and represented 80% of the age-eligible population. The baseline characteristics showed increased levels of traditional cardiovascular risk factors in individuals of the highest CRP tertile. Participants in the highest CRP tertile had almost 4 times the risk for a CKD-related hospitalisation compared with participants in the lowest tertile (HR = 3.91, 95%CI 1.01-15.20, p = 0.049) after adjustment for potential confounding factors. Participants with CRP concentrations greater than 3 mg/L had almost 3 times the risk of CKD hospitalisations than those ≤3 mg/L (HR = 2.84, 95%CI 1.00-8.00, p = 0.049). Furthermore, risk for CKD increased 34% per doubled increase in CRP (HR = 1.34, 95%CI 1.04-1.74, p = 0.024).

Conclusions
Elevated C-reactive protein levels can predict the risk for CKD almost a decade prior to an incident CKD-related hospitalisation in individuals of this remote indigenous community. Further research is needed to understand the role CRP and systemic inflammation plays in CKD risk.
Keyword Urology & Nephrology
Urology & Nephrology
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID APP1025300
511081
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Admin Only - School of Medicine
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 0 times in Thomson Reuters Web of Science Article
Scopus Citation Count Cited 0 times in Scopus Article
Google Scholar Search Google Scholar
Created: Tue, 21 Jun 2016, 19:55:27 EST by Zhiqiang Wang on behalf of Medicine - Royal Brisbane and Women's Hospital