Circulating renalase predicts all-cause mortality and renal outcomes in patients with advanced chronic kidney disease

• Published in: The Korean journal of internal medicine Vol. 34; no. 4; pp. 858 - 866
• Main Authors: Baek, Seon Ha, Cha, Ran-Hui, Kang, Shin Wook, Park, Cheol Whee, Cha, Dae Ryong, Kim, Sung Gyun, Yoon, Sun Ae, Kim, Sejoong, Han, Sang-Youb, Park, Jung Hwan, Chang, Jae Hyun, Lim, Chun Soo, Kim, Yon Su, Na, Ki Young
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Association of Internal Medicine 01-07-2019; 대한내과학회
• Subjects: Adult; Aged; Biomarkers - blood; Cause of Death; chronic kidney disease; Disease Progression; end-stage renal disease; Female; Humans; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - diagnosis; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - therapy; Male; Middle Aged; Monoamine Oxidase - blood; mortality; Original; Predictive Value of Tests; Prognosis; Randomized Controlled Trials as Topic; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - mortality; Renal Insufficiency, Chronic - therapy; renalase; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Up-Regulation; 내과학; End-stage renal disease; Renalase; Chronic kidney disease; Mortality
• ISSN: 1226-3303; 2005-6648
• DOI: 10.3904/kjim.2017.058

Patients with chronic kidney disease (CKD) have been found to show markedly increased rates of end-stage renal disease, major adverse cardiovascular and cerebrovascular events (MACCEs), and mortality. Therefore, new biomarkers are required for the early detection of such clinical outcomes in patients with CKD. We aimed to determine whether the level of circulating renalase was associated with CKD progression, MACCEs, and all-cause mortality, using data from a prospective randomized controlled study, Kremezin STudy Against Renal disease progression in Korea (K-STAR; NCT00860431).
A retrospective analysis of the K-STAR data was performed including 383 patients with CKD (mean age, 56.4 years; male/female, 252/131). We measured circulating renalase levels and examined the effects of these levels on clinical outcomes.
The mean level of serum renalase was 75.8 ± 34.8 μg/mL. In the multivariable analysis, lower hemoglobin levels, higher serum creatinine levels, and diabetes mellitus were significantly associated with a higher renalase levels. Over the course of a mean follow-up period of 56 months, 25 deaths and 61 MACCEs occurred. Among 322 patients in whom these outcomes were assessed, 137 adverse renal outcomes occurred after a mean follow-up period of 27.8 months. Each 10- μg/mL increase in serum renalase was associated with significantly greater hazards of all-cause mortality and adverse renal outcomes (hazard ratio [HR] = 1.112, p = 0.049; HR = 1.052, p = 0.045). However, serum renalase level was not associated with the rate of MACCEs in patients with CKD.
Our results indicated that circulating renalase might be a predictor of mortality and adverse renal outcomes in patients with CKD.