Relationship between serum neutrophil gelatinase-associated apolipoprotein and cardiovascular events in patients with chronic renal disease

Objective To investigate the relationship between (serum neutrophil gelatinase-associated lipocalin, sNGAL) and cardiovascular events in patients with chronic kidney disease (CKD) . Methods 300 patients with CKD were divided into two groups according to the level of sNGAL: high sNGAL group (n=158) and low sNGAL group (n=142) . The incidence of cardiovascular events and cumulative survival rate were analyzed by ROC curve, and the correlation between sNGAL and cardiovascular risk factors, cardiovascular events in patients with chronic renal disease was analyzed. Influencing factors of cardiovascular events in CKD patients was analyzed. Results There were significant differences in the data about BMI, diabetes proportion, CKD staging, eGFR, hs-CRP, 24h proteinuria, HDL, iPTH, phosphate and blood calcium between the two groups (P<0.05) . The 3-year cumulative survival rate of high sNGAL group (77.2%) was significantly lower than that of low sNGAL group (96.5%) , and the 3-year incidence of cardiovascular events (37.9%) was significantly higher than that of low sNGAL group (9.8%) (P< 0.05) . AUC in diagnosing cardiovascular events in high sNGAL group (0.746) was significantly higher than that in eGFR (0.636) , age (0.504) , serum calcium (0.545) , HDL (0.594) and LDL (0.508, all P<0.05) . There was a significant correlation between sNGAL and eGFR, HDL, BMI, hs-CRP, iPTH and phosphate (P<0.05) . Both univariate and multivariate factors COX showed that sNGAL was a risk factor of cardiovascular events in patients with CKD (P<0.05) , ( (HR=1.976 and 1.588, 95% CI=1.443-2.724 and 1.144-2.143, respectively, P=0.000 and 0.000) ) . Conclusions The incidence of cardiovascular events in patients with CKD with high sNGAL is significantly increased. sNGAL is an independent factor of cardiovascular events in patients with chronic renal disease. Key words: Chronic renal disease; Neutrophil gelatinase-associated apolipoprotein; Cardiovascular events; prognosis