Increased Levels of Copeptin, a Surrogate Marker of Arginine Vasopressin, Are Associated with an Increased Risk of Chronic Kidney Disease in a General Population

• Published in: American journal of nephrology Vol. 44; no. 1; pp. 22 - 28
• Main Authors: Tasevska, Irina, Enhörning, Sofia, Christensson, Anders, Persson, Margaretha, Nilsson, Peter M., Melander, Olle
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland 01.01.2016
• Subjects: Cohort Studies; Female; Glomerular Filtration Rate; Glycopeptides - blood; Humans; Male; Middle Aged; Original Report: Patient-Oriented, Translational Research; Renal Insufficiency, Chronic - blood; Risk Factors; Chronic kidney disease; Estimated glomerular filtration rate; Epidemiology; Copeptin
• ISSN: 0250-8095; 1421-9670
• DOI: 10.1159/000447522

Background: Our aim was to test if plasma copeptin, a stable surrogate marker of arginine vasopressin, predicts decline of glomerular filtration rate (GFR) and risk of chronic kidney disease (CKD). Methods: We measured copeptin and renal function at the Malmö Diet and Cancer Cardiovascular Cohort baseline exam and reassessed renal function after a follow-up time of 16.6 ± 1.5 years (n = 3,186). Furthermore, we defined CKD based on an estimated GFR (eGFR) calculated by the Modification of Diet in Renal Disease (MDRD) <60 (CKD_60 MDRD ), <45 (CKD_45 MDRD ) and <30 (CKD_30 MDRD ) ml/min/1.73 m 2 . Results: After multivariate adjustment (gender, age, baseline eGFR, smoking status, systolic blood pressure, antihypertensive treatment and follow-up time), copeptin (beta-coefficient per 1 SD increment of copeptin) was independently associated with significantly greater annual decline of eGFR (ml/min/1.73 m 2 ) according to the MDRD formula (OR 0.057, 95% CI 0.022-0.093; p = 0.001) as well as according to the CKD Epidemiology Collaboration (CKD-EPI) formula (OR 0.050, 95% CI 0.022-0.077; p < 0.001). Each SD increment of copeptin independently predicted incident CKD_60 MDRD (OR 1.19, 95% CI 1.04-1.36; p = 0.010), CKD_45 MDRD (OR 1.33, 95% CI 1.04-1.71; p = 0.026) and CKD_30 MDRD (OR 3.69, 95% CI 1.41-9.66; p = 0.008). The relationship between copeptin and CKD defined by CKD-EPI gave similar results. Conclusion: Our data suggest that increased levels of copeptin independently predict decline in eGFR and greater risk of new-onset CKD.