RT info:eu-repo/semantics/article
T1 Endothelin-1 as dual marker for renal function decline and associated cardiovascular complications in patients with chronic kidney disease
A1 González Rodríguez, Laura
A1 Martí-Antonio, Manuel
A1 Mota Zamorano, Sonia
A1 Chicharro Miguel, Celia
A1 Cancho, Bárbara
A1 Luna, Enrique
A1 Álvarez, Álvaro
A1 Verde Rello, Zoraida
A1 Bandrés, Fernando
A1 Robles, Nicolás Roberto
A1 Gervasini, Guillermo
AB Background: Cardiovascular (CV) complications are the leading cause of death in patients with chronic kidney disease (CKD). Endothelin-1 (ET-1), a potent vasoconstrictor involved in both renal and vascular dysfunction, may represent a promising biomarker for the disease.Methods: ET-1 plasma levels were quantified in 692 Spanish CKD patients (stages 1-5) and used to stratify individuals into three clusters (cluster 3 meaning highest concentrations). Associations with CKD progression, CVE, and all-cause mortality were assessed over a mean follow-up of 48.6 ± 27.4 months using linear mixed-effects models and Cox regression analyses adjusted for conventional risk factors.Results: ET-1 levels increased with CKD severity (mean±SD: 1.65 ± 0.71 pg/mL for stages 1-2; 1.82 ± 0.71 pg/mL for stage 3; 2.39 ± 1.08 pg/mL for stages 4-5; p < 0.001). Higher ET-1 levels were independently associated with accelerated eGFR decline over 3 years (β = -12.64, p < 0.001 for cluster 2; and β = -11.71, p = 0.034 for cluster 3). Sixty-nine CVE (10.1 %) were recorded. Participants with higher ET-1 levels had significantly lower CV event-free survival [HR = 2.24 (1.12-4.45), p = 0.022, and HR = 2.50 (1.09-5.73), p = 0.03] for clusters 2 and 3, respectively. ET-1 also predicted all-cause mortality (p < 0.001) although the association lost significance after adjusting for age. Random forest models for CV risk and all-cause mortality including the ET-1 cluster produced C-indices of 0.835 and 0.837, respectively.Conclusions: Elevated ET-1 levels are independently associated with both CKD progression and CV complications. ET-1 may serve as a dual biomarker for renal deterioration and CV risk, potentially improving clinical stratification in CKD management.
PB ELSEVIER
SN 0953-6205
YR 2025
FD 2025
LK https://uvadoc.uva.es/handle/10324/81723
UL https://uvadoc.uva.es/handle/10324/81723
LA eng
NO Eur J Intern Med., 2025, 9,106542.
DS UVaDOC
RD 03-abr-2026