Increased Circulating Visfatin Is Associated With Progression of Kidney Disease in Non-Diabetic Hypertensive Patients

Am J Hypertens. 2016 Apr;29(4):528-36. doi: 10.1093/ajh/hpv132. Epub 2015 Aug 22.

Abstract

Backgroud: Declining renal function is an independent risk factor for all-cause mortality in cardiovascular disease. Visfatin has been described as a marker of inflammation and endothelial dysfunction, but whether circulating visfatin levels are predictive to a subsequent decline in renal function remains unclear.

Methods: In total, 200 nondiabetic, non-proteinuric hypertensive outpatients with initial serum creatinine (Scr) ≤1.5 mg/dl were enrolled. Plasma visfatin concentration and endothelial function estimated by brachial artery flow-mediated dilatation (FMD) were determined in the study subjects. The primary endpoints were the occurrence of renal events including doubling of Scr, 25% loss of glomerular filtration rate (GFR) from baseline values, and the occurrence of end-stage renal disease during follow-up.

Results: The mean annual rate of GFR decline (ΔGFR/y) was -1.26±2.76 ml/min/1.73 m(2) per year during follow-up (8.6±2.5 years). At baseline, plasma visfatin was negatively correlated with estimated GFR. In longitudinal analysis, the ΔGFR/y was correlated with visfatin, baseline GFR, FMD, systolic blood pressure, and fasting blood glucose (FBG). Multivariate analysis indicated that increased visfatin (r = -0.331, P <0.001), baseline GFR (r = -0.234, P = 0.001), FMD (r = 0.163, P = 0.015), and FBG (r = -0.160, P = 0.015) are independent predictors of ΔeGFR/y. Cox regression model analysis showed that visfatin (hazard ratio (HR), 1.09; 95% confidence interval (CI), 1.05-1.13, P <0.001), FBG (HR, 1.01; 95% CI, 1.00-1.02, P = 0.020), and FMD (HR, 0.87; 95% CI, 0.76-1.00, P = 0.049) were independently associated with the risk of developing future renal events.

Conclusions: Increased circulating visfatin are associated with subsequent decline in renal function in nondiabetic hypertensive patients.

Keywords: adipokine; blood pressure; chronic kidney disease; endothelial dysfunction; hypertension; visfatin..

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Blood Pressure
  • Chi-Square Distribution
  • Creatinine / blood
  • Cytokines / blood*
  • Disease Progression
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypertension / complications*
  • Hypertension / diagnosis
  • Hypertension / physiopathology
  • Kaplan-Meier Estimate
  • Kidney / physiopathology
  • Kidney Diseases / blood
  • Kidney Diseases / diagnosis
  • Kidney Diseases / etiology*
  • Kidney Diseases / physiopathology
  • Kidney Failure, Chronic / etiology
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nicotinamide Phosphoribosyltransferase / blood*
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Up-Regulation

Substances

  • Biomarkers
  • Cytokines
  • Creatinine
  • Nicotinamide Phosphoribosyltransferase
  • nicotinamide phosphoribosyltransferase, human