Elevation of circulating TNF receptors 1 and 2 increases the risk of end-stage renal disease in American Indians with type 2 diabetes.

摘要: In Caucasians with type 2 diabetes, circulating TNF receptors 1 (TNFR1) and (TNFR2) predict end-stage renal disease (ESRD). Here we examined this relationship in a longitudinal cohort study of American Indians diabetes measured glomerular filtration rate (mGFR, iothalamate) urinary albumin-to-creatinine ratio (ACR). ESRD was defined as dialysis, kidney transplant, or death attributed to diabetic disease. Age-gender-adjusted incidence rates ratios were computed by Mantel–Haenszel stratification. The hazard assessed per interquartile range increase the distribution each TNFR after adjusting for baseline age, gender, mean blood pressure, HbA1c, ACR, mGFR. Among 193 participants, 62 developed 25 died without during median follow-up 9.5 years. age-gender-adjusted higher among participants highest versus lowest quartile TNFR1 (6.6, 95% confidence interval (CI) 3.3–13.3) TNFR2 (8.8, CI 4.3–18.0). fully adjusted model, risk 1.6 times (95% 1.1–2.2) high 1.7 1.2–2.3) TNFR2. Thus, elevated serum concentrations are associated increased accounting traditional factors including ACR