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Predictive value of ADAMTS-13 on concealed chronic renal failure in COPD patients

Authors Zeng M, Chen QG, Liang WJ, He WM, Zheng HC, Huang CR

Received 18 September 2017

Accepted for publication 3 November 2017

Published 5 December 2017 Volume 2017:12 Pages 3495—3501

DOI https://doi.org/10.2147/COPD.S151983

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Charles Downs

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Chunxue Bai


Mian Zeng, Qingui Chen, Wenjie Liang, Wanmei He, Haichong Zheng, Chunrong Huang

Department of Medical Intensive Care Unit, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

Background: Impaired renal function is often neglected in COPD patients. Considering that COPD patients usually have an ongoing prothrombotic state and systemic inflammation status, we investigated the association among them and explored the predictive value of a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS-13), on concealed chronic renal failure (CRF) in COPD patients.
Methods: COPD patients were recruited from the First Affiliated Hospital of Sun Yat-Sen University between January 2015 and December 2016. Control was selected from contemporaneous hospitalized patients without COPD and matched by age and gender at a ratio of 1:1. Estimated glomerular filtration rate (eGFR) was calculated by using the Chronic Kidney Disease Epidemiology Collaboration formula, and all subjects were categorized as having normal renal function (eGFR ≥60 mL min–1 1.73 m–2) and having concealed CRF (normal serum creatinine while eGFR <60 mL min–1 1.73 m–2). Independent correlates of concealed CRF were investigated by logistic regression analysis, and receiver operating characteristic (ROC) curves were used to determine the predictive value of ADAMTS-13.
Results: In total, 106 COPD and 106 non-COPD patients were finally recruited, and the incidences of concealed CRF were 19.81% and 7.55%, respectively. ADAMTS-13 (odds ratio [OR] =0.858, 95% CI =0.795–0.926), D-dimer (OR =1.095, 95% CI =1.027–1.169), and C-reactive protein (OR =1.252, 95% CI =1.058–1.480) were significantly associated with concealed CRF. Sensitivity and specificity at an ADAMTS-13 cutoff of 318.72 ng/mL were 100% and 81.2%, respectively. The area under the ROC curve was 0.959.
Conclusion: Prothrombotic state and systemic inflammation status might contribute to explaining the high incidence of concealed CRF in COPD, and plasma ADAMTS-13 levels may serve as a strong predictor.

Keywords:
chronic obstructive pulmonary disease, renal insufficiency, thrombosis, inflammation, ADAMTS-13 protein

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