Soluble Urokinase Receptor and XXXX .

@entity1 @entity628 @entity740
BACKGROUND: Relatively high plasma levels of soluble urokinase-type plasminogen activator receptor (suPAR) have been associated with @entity628 and poor clinical outcomes in @entity1 with various conditions. It is unknown whether elevated suPAR levels in @entity1 with normal kidney function are associated with future decline in the estimated glomerular filtration rate (eGFR) and with @entity740 . METHODS: We measured plasma suPAR levels in 3683 @entity1 enrolled in the Emory Cardiovascular Biobank (mean age, 63 years; 65% @entity1 ; median suPAR level, 3040 pg per milliliter) and determined renal function at enrollment and at subsequent visits in 2292 @entity1 . The relationship between suPAR levels and the eGFR at baseline, the change in the eGFR over time, and the development of @entity740 (eGFR <60 ml per minute per 1.73 m(2) of body-surface area) were analyzed with the use of linear mixed models and Cox regression after adjustment for demographic and clinical variables. RESULTS: A higher suPAR level at baseline was associated with a greater decline in the eGFR during follow-up; the annual change in the eGFR was -0.9 ml per minute per 1.73 m(2) among @entity1 in the lowest quartile of suPAR levels as compared with -4.2 ml per minute per 1.73 m(2) among @entity1 in the highest quartile (P<0.001). The 921 @entity1 with a normal eGFR (>=  90 ml per minute per 1.73 m(2)) at baseline had the largest suPAR-related decline in the eGFR. In 1335 @entity1 with a baseline eGFR of at least 60 ml per minute per 1.73 m(2), the risk of progression to @entity740 in the highest quartile of suPAR levels was 3.13 times as high (95% confidence interval, 2.11 to 4.65) as that in the lowest quartile. CONCLUSIONS: An elevated level of suPAR was independently associated with @entity740 and an accelerated decline in the eGFR in the groups studied. (Funded by the Abraham J. and Phyllis Katz Foundation and others.).
