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Cited by 5Amyotrophic Lateral Sclerosis ResearchChronic Kidney Disease and DiabetesDementia and Cognitive Impairment Research

Cystatin C based estimation of chronic kidney disease and amyotrophic lateral sclerosis in the ALS registry Swabia: associated risk and prognostic value

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Nagel, Gabriele, Kurz, Deborah, Peter, Raphael S., Rosenbohm, Angela, Koenig, Wolfgang, Dupuis, Luc, Bäzner, Hansjörg, Börtlein, Axel +11 more·2023·Scientific Reports
DOI 10.1038/s41598-023-46179-9PMC PMC10638424
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Abstract

Kidney function as part of metabolic changes could be associated with amyotrophic lateral-sclerosis (ALS). We investigated the associations between estimated chronic kidney disease (CKD), based on the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) cystatin C equation, and the risk at onset and prognostic value of CKD for ALS. Between October 2010 and June 2014, 362 ALS cases (59.4% men, mean age 65.7 years) and 681 controls (59.5% men, means age 66.3 years) were included in a population-based case–control study based on the ALS registry Swabia in Southern Germany. All ALS cases were followed-up (median 89.7 months), 317 died. Serum samples were measured for cystatin C to estimate the glomerular filtration rate (eGFR) according to the CKD-EPI equation. Information on covariates were assessed by an interview-based standardized questionnaire. Conditional logistic regression models were applied to calculate odds ratios (OR) for risk of ALS associated with eGFR/CKD stages. Time-to-death associated with renal parameters at baseline was assessed in ALS cases only. ALS cases were characterized by lower body mass index, slightly lower smoking prevalence, more intense occupational work and lower education than controls. Median serum cystatin-C based eGFR concentrations were lower in ALS cases than in controls (54.0 vs. 59.5 mL/min pro 1.73 m 2). The prevalence of CKD stage ≥ 3 was slightly higher in ALS cases than in controls (14.1 vs. 11.0%). In the adjusted models, CKD stage 2 (OR 1.82, 95% CI 1.32, 2.52) and stage 3 (OR 2.34, 95% CI 1.38, 3.96) were associated with increased ALS risk. In this cohort of ALS cases, eGFR and CKD stage ≥ 3 (HR 0.94; 95% CI 0.64, 1.38) were not associated with prognosis. In this case–control study, higher CKD stages were associated with increased ALS risk, while in the prospective cohort of ALS cases, no indication of an association of CysC-based CKD on mortality was seen. In addition, our work strengthens the importance to evaluate renal function using a marker independent of muscle mass in ALS patients.

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Authors
Nagel, G., Kurz, D., Peter, R. S., Rosenbohm, A., Koenig, W., Dupuis, L., Bäzner, H., Börtlein, A., Dempewolf, S., Schabet, M., Hecht, M., Kohler, A., Opherk, C., Naegele, A., Sommer, N., Lindner, A., Tumani, H., Ludolph, A. C., & Rothenbacher, D.
Affiliations
  • Universität Ulm (DE)
  • Inserm (FR)
  • Klinikum Stuttgart (DE)
  • Klinikum Ludwigsburg (DE)
  • SLK-Kliniken Heilbronn (DE)
  • Marienhospital Stuttgart (DE)
Corresponding author
Nagel, Gabriele
ORCID
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2023-11-10
Volume
13
Issue
1
Pages
19594-19594
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-023-46179-9
PMC
PMC10638424
OpenAlex
W4388568232
Cited by
5
References
0
Citations by year
2025: 1 · 2024: 4
FWCI
0.85
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DZNE Pub (submittedVersion, cc-by)
  • HAL (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
  • OPen Access Repositorium der Universität Ulm (OPARU) (Ulm University) (submittedVersion, cc-by)
  • Universität Ulm, Kommunikations- und Informationszentrum (kiz) (cc-by)
Funders
Universität Ulm
Topics
  • Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
amyotrophic lateral sclerosis, chronic kidney disease, cystatin C, glomerular filtration rate, CKD-EPI equation, ALS risk, prognosis, mortality, renal function
MeSH terms
Aged, Amyotrophic Lateral Sclerosis, Creatinine, Female, Glomerular Filtration Rate, Humans, Male, Prognosis, Prospective Studies, Registries, Biomarkers, Case-Control Studies, Renal Insufficiency, Chronic, Cystatin C

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