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Evaluation of cardiovascular events and progression to end-stage renal disease in patients with dyslipidemia and chronic kidney disease from the North-Eastern area of Romania

  • Nephrology - Original Paper
  • Published:
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Abstract

Purpose

The aim of this prospective cohort study was: to identify the association between different biomarkers [proprotein convertase subtilisin/kexin 9-PCSK9, lipoprotein(a)-Lp(a) and high‐sensitivity C‐reactive protein-hsCRP] and the cardiovascular events; to evaluate the relationship between the 3 biomarkers mentioned above and the renal outcomes that contributed to end-stage renal disease (ESRD).

Methods

We studied 110 patients with chronic kidney disease (CKD) stages 2 to 4. The identification of the new cardiovascular events and the renal outcomes were performed by clinical and paraclinical explorations.

Results

350 patients were examined and 110 (31.4%) were included in this study. The mean age was 55.6 ± 10.9 years, with a higher number of men compared to women. The CKD patients with de novo cardiovascular events and new renal outcome during the study, had significantly increased values of total cholesterol (TC), low density cholesterol lipoprotein (LDL-C) at 6 and 12 months and higher levels of Lp(a), PCSK9, hsCRP and low ankle–brachial index (ABI) and ejection fraction (EF) values compared to patients without cardiovascular and renal events. In CKD patients, PCSK9 > 220 ng/mL was a predictor of cardiovascular events, while the EF < 50% was a predictor for renal outcomes. For CKD patients with PCSK9 > 220 ng/mL and hsCRP > 3 mg/L levels, the time-interval for the new cardiovascular and renal events occurrence were significantly decreased compared to patients displaying low values of these biomarkers.

Conclusion

The results of this study show that PCSK9 > 220 ng/mL was predictor for cardiovascular events, while EF < 50% was predictor for CKD progression to ESRD. PCSK9 > 220 ng/mL and hsCRP > 3 mg/L were associated with the occurrence of renal and cardiovascular events earlier.

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Availability of data and material

The data and material of this study are available from the author (L.F.) on reasonable request.

Abbreviations

CKD:

Chronic kidney disease

ASCVD:

Atherosclerotic cardiovascular disease

CVD:

Cardiovascular diseases

CHD:

Coronary heart disease

PAD:

Peripheral arterial disease

ABI:

Ankle–brachial index

ECG:

Electrocardiogram

LV:

Left ventricular

EF:

Ejection fraction

TC:

Total cholesterol

LDL-C:

Low density cholesterol lipoprotein

HDL-C:

High density cholesterol lipoprotein

TG:

Triglycerides

hsCRP:

High-sensitivity C-reactive protein

PCSK9:

Proprotein convertase subtilisin/kexin 9

Lp(a):

Lipoprotein(a)

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Funding

AC: was supported by a grant of Ministry of Research and Innovation, CNCS—UEFISCDI, project number PN-III-P4-ID-PCE-2016-0908, contract number 167/2017, within PNCDI III.

Author information

Author notes

  1. Cristiana-Elena Vlad, Mariana Pavel-Tanasa and Laura Florea have contributed equally to this work.

Authors and Affiliations

  1. Department of Nephrology-Internal Medicine, “Dr. C. I. Parhon” Clinical Hospital Iasi, Iasi, Romania

    Cristiana-Elena Vlad, Laura Florea & Adrian Covic

  2. “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania

    Cristiana-Elena Vlad, Liliana Foia, Mariana Pavel-Tanasa, Vasilica Toma, Laura Florea, Luminita Voroneanu, Mugurel Apetrii, Gianina Dodi & Adrian Covic

  3. The Academy of Romanian Scientists (AOSR), Bucharest, Romania

    Adrian Covic

  4. Departament of Biochemistry, “Grigore T. Popa” University of Medicine and Pharmacy, Universitatii Street, 700115, Iasi, Romania

    Liliana Foia

Authors
  1. Cristiana-Elena Vlad
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  2. Liliana Foia
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  3. Mariana Pavel-Tanasa
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Contributions

CEV, MPT analyzed and interpreted the patients’ data regarding the CKD criteria. CEV, AC, LF, LF, LV, MA, GD performed the clinical and imagistic examination. CEV, MPT, LF, AC were major contributors in writing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Liliana Foia.

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Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

Ethical approval

After the approval of the Informed Consent by the Ethics Commission of “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, of “Dr. C. I Parhon” Clinical Hospital, the consent was signed by all the patients prior to their enrollment in the study. The research could not involve any physical or mental discomfort for the patients included in the study, nor any physical or mental risks, or obligation to participate in the study. The confidentiality of the personal and medical data of the subjects enrolled in the study was preserved.

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Vlad, CE., Foia, L., Pavel-Tanasa, M. et al. Evaluation of cardiovascular events and progression to end-stage renal disease in patients with dyslipidemia and chronic kidney disease from the North-Eastern area of Romania. Int Urol Nephrol 54, 647–659 (2022). https://doi.org/10.1007/s11255-021-02919-2

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  • DOI: https://doi.org/10.1007/s11255-021-02919-2

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