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Study of the association between serum levels of kynurenine and cardiovascular outcomes and overall mortality in chronic kidney disease

dc.rights.licenseopenen_US
dc.contributor.authorCHAMIEH, Carolla El
dc.contributor.authorLARABI, Islam Amine
dc.contributor.authorDE PINHO, Natalia Alencar
dc.contributor.authorLAMBERT, Oriane
hal.structure.identifierBioingénierie tissulaire [BIOTIS]
dc.contributor.authorCOMBE, Christian
dc.contributor.authorFOUQUE, Denis
dc.contributor.authorFRIMAT, Luc
dc.contributor.authorJACQUELINET, Christian
dc.contributor.authorLAVILLE, Maurice
dc.contributor.authorLAVILLE, Solène
dc.contributor.authorLANGE, Céline
dc.contributor.authorALVAREZ, Jean-Claude
dc.contributor.authorMASSY, Ziad A.
dc.contributor.authorLIABEUF, Sophie
dc.date.accessioned2025-03-20T15:17:28Z
dc.date.available2025-03-20T15:17:28Z
dc.date.issued2024-01
dc.identifier.issn2048-8505en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/205587
dc.description.abstractEnBackground. Kynurenine is a protein-bound uremic toxin. Its circulating levels are increased in chronic kidney disease (CKD). Experimental studies showed that it exerted deleterious cardiovascular effects. We sought to evaluate an association between serum kynurenine levels and adverse fatal or nonfatal cardiovascular events and all-cause mortality in CKD patients. Methods. The CKD-REIN study is a prospective cohort of people with CKD having an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Baseline frozen samples of total and free fractions of kynurenine and tryptophan were measured using a validated liquid chromatography tandem mass spectrometry technique. Cause-specific Cox models were used to estimate hazard ratios (HRs) for each outcome. Results. Of the 2406 included patients (median age: 68 years; median eGFR: 25 ml/min/1.73 m2), 52% had a history of cardiovascular disease. A doubling of serum-free kynurenine levels was associated with an 18% increased hazard of cardiovascular events [466 events, HR (95%CI):1.18(1.02,1.33)], independently of eGFR, serum-free tryptophan level or other uremic toxins, cardioprotective drugs, and traditional cardiovascular risk factors. Serum-free kynurenine was significantly associated with non-atheromatous cardiovascular events [HR(95%CI):1.26(1.03,1.50)], but not with atheromatous cardiovascular events [HR(95%CI):1.15(0.89,1.50)]. The association of serum-free kynurenine with cardiovascular mortality was also independently significant [87 events; adjusted HR(95%CI):1.64(1.10,2.40)]. However, the association of serum-free kynurenine with all-cause mortality was no more significant after adjustment on serum-free tryptophan [311 events, HR(95%CI):1.12(0.90, 1.40)]. Conclusions. Our findings imply that serum-free kynurenine, independently of other cardiovascular risk factors (including eGFR), is associated with fatal or nonfatal cardiovascular outcomes, particularly non-atheromatous cardiovascular events; in patients with CKD. Strategies to reduce serum kynurenine levels should be evaluated in further studies. © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.subjectAll-cause mortality
dc.subjectCardiovascular disease
dc.subjectChronic kidney disease
dc.subjectKynurenine
dc.title.enStudy of the association between serum levels of kynurenine and cardiovascular outcomes and overall mortality in chronic kidney disease
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/ckj/sfad248en_US
dc.subject.halSciences du Vivant [q-bio]en_US
bordeaux.journalClinical Kidney Journalen_US
bordeaux.volume17en_US
bordeaux.hal.laboratoriesBioingénierie Tissulaire (BioTis) - U1026en_US
bordeaux.issue1en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionCNRSen_US
bordeaux.institutionINSERMen_US
bordeaux.institutionCHU de Bordeauxen_US
bordeaux.institutionInstitut Bergoniéen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
dc.rights.ccCC BYen_US
bordeaux.COinSctx_ver=Z39.88-2004&amp;rft_val_fmt=info:ofi/fmt:kev:mtx:journal&amp;rft.jtitle=Clinical%20Kidney%20Journal&amp;rft.date=2024-01&amp;rft.volume=17&amp;rft.issue=1&amp;rft.eissn=2048-8505&amp;rft.issn=2048-8505&amp;rft.au=CHAMIEH,%20Carolla%20El&amp;LARABI,%20Islam%20Amine&amp;DE%20PINHO,%20Natalia%20Alencar&amp;LAMBERT,%20Oriane&amp;COMBE,%20Christian&amp;rft.genre=article


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