DKK3 for Prognosis and Monitoring of GFR Decline in Heart Failure

University of Giessen290 enrolled

Overview

The individual course of chronic kidney disease (CKD) may vary, and improved methods for identifying which patients will experience estimated glomerular filtration rate (eGFR) decline are needed. Recently, urinary dickkopf-3 (DKK3) has been proposed to predict eGFR decline in patients with CKD, independent of presence of albuminuria. The investigators sought to examine the association between changes in DKK3 levels and eGFR decline in patients with heart failure (HF).

The individual course of chronic kidney disease (CKD) may vary, and improved methods for identifying which patients will experience estimated glomerular filtration rate (eGFR) decline are needed. Recently, urinary dickkopf-3 (DKK3) has been identified as an stress-induced, renal tubular epithelia-derived, secreted glycoprotein that induces tubulointerstitial fibrosis. Urinary DKK3 has been found to predict eGFR decline in patients with CKD, independent of presence of albuminuria, but its association with eGFR decline in patients with heart failure (HF) is unknown. The investigators sought to examine the association between changes in DKK3 and eGFR decline in patients with HF.

Study Type

OBSERVATIONAL

Enrollment

290

Conditions

Heart Failure Chronic Kidney Diseases

Interventions

No interventionDIAGNOSTIC_TEST

No intervention

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Outpatients ≥18 years of age with diagnosed HF or diabetes or hypertension Exclusion Criteria: * CKD with estimated GFR \<20 ml/min/1.73 m2 (2012 CKD-EPI equation) * CKD with extracorporeal or peritoneal ultrafiltration due to diuretic-resistant fluid overload * active tumor disease * inflammatory or autoimmune disease requiring systemic immunosuppressive treatment * clinically apparent infections * recipients of solid-organ transplants * anticipated life expectancy of \<12 months * likelihood of receiving advanced therapy (mechanical circulatory assist device/cardiac transplant) * pregnancy or possibility of pregnancy in the next 12 months

Locations (1)

University Clinic Giessen and Marburg - Campus Giessen

Giessen, Hesse, Germany

Outcomes

Primary Outcomes

Association between DKK3 and eGFR decline

DKK3 and eGFR (CKD-Epidemiology Collaboration equation)

Time frame: 24 months

Secondary Outcomes

Association between proteinuria and DKK3

DKK3 and proteinuria, albuminuria, and alpha 1 microglobulin excretion

Time frame: 24 months

Persistent or worsening of HF

Cardiovascular death, hospital admission for decompensated HF, or clinical HF decompensation without hospital admission (but requiring parenteral HF therapy or changes in oral HF medications including diuretics)

Time frame: 24 months

Need for renal replacement therapy

Requirement of incident renal replacement therapy

Time frame: 24 months

Association of venous congestion/volume overload with DKK3

B-type natriuretic peptide, clinical examination, bioimpedance analysis, echocardiography

Time frame: 24 months

Association of right and left ventricular function with DKK3

Echocardiography

Time frame: 24 months

Data from ClinicalTrials.gov

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