Results from the German Chronic Kidney Disease (GCKD) study support association of relative telomere length with mortality in a large cohort of patients with moderate chronic kidney disease
Creators: name: Fazzini, Federica
name: Lamina, Claudia
name: Raschenberger, Julia
name: Schultheiss, Ulla T.
name: Kotsis, Fruzsina
name: Schönherr, Sebastian
name: Weissensteiner, Hansi
name: Forer, Lukas
name: Steinbrenner, Inga
name: Meiselbach, Heike
name: Bärthlein, Barbara
name: Wanner, Christoph
name: Eckardt, Kai-Uwe
name: Köttgen, Anna
name: Kronenberg, Florian
name: Eckardt, Kai-Uwe
name: Meiselbach, Heike
name: Schneider, Markus
name: Dienemann, Thomas
name: Prokosch, Hans-Ulrich
name: Bärthlein, Barbara
name: Beck, Andreas
name: Ganslandt, Thomas
name: Reis, André
name: Ekici, Arif B.
name: Avendaño, Susanne
name: Becker-Grosspitsch, Dinah
name: Alberth-Schmidt, Ulrike
name: Hausknecht, Birgit
name: Zitzmann, Rita
name: Weigel, Anke
name: Walz, Gerd
name: Köttgen, Anna
name: Schultheiß, Ulla T.
name: Kotsis, Fruzsina
name: Meder, Simone
name: Mitsch, Erna
name: Reinhard, Ursula
name: Floege, Jürgen
name: Schlieper, Georg
name: Saritas, Turgay
name: Ernst, Sabine
name: Beaujean, Nicole
name: Schaeffner, Elke
name: Baid-Agrawal, Seema
name: Theisen, Kerstin
name: Haller, Hermann
name: Menne, Jan
name: Zeier, Martin
name: Sommerer, Claudia
name: Woitke, Rebecca
name: Wolf, Gunter
name: Busch, Martin
name: Fuß, Rainer
name: Sitter, Thomas
name: Blank, Claudia
name: Wanner, Christoph
name: Krane, Vera
name: Börner-Klein, Antje
name: Bauer, Britta
name: Kronenberg, Florian
name: Raschenberger, Julia
name: Kollerits, Barbara
name: Forer, Lukas
name: Schönherr, Sebastian
name: Weissensteiner, Hansi
name: Oefner, Peter
name: Gronwald, Wolfram
name: Zacharias, Helena
name: Schmid, Matthias
name: Nadal, Jennifer
Publisher: name: Universität Regensburg
Year: 2020
Subjects: subject: chronic kidney disease; infections; mortality; relative telomere length.
subject: 610 Medizin

description: Telomere length is known to be inversely associated with aging and has been proposed as a marker for aging-related diseases. Telomere attrition can be accelerated by oxidative stress and inflammation, both commonly present in patients with chronic kidney disease. Here, we investigated whether relative telomere length is associated with mortality in a large cohort of patients with chronic kidney disease stage G3 and A1-3 or G1-2 with overt proteinuria (A3) at enrollment. Relative telomere length was quantified in peripheral blood by a quantitative PCR method in 4,955 patients from the GCKD study, an ongoing prospective observational cohort. Complete four-year follow-up was available from 4,926 patients in whom we recorded 354 deaths. Relative telomere length was a strong and independent predictor of all-cause mortality. Each decrease of 0.1 relative telomere length unit was highly associated with a 14% increased risk of death (hazard ratio1.14 [95% confidence interval 1.06-1.22]) in a model adjusted for age, sex, baseline eGFR, urine albumin/creatinine ratio, diabetes mellitus, prevalent cardiovascular disease, LDL-cholesterol, HDL-cholesterol, smoking, body mass index, systolic and diastolic blood pressure, C-reactive protein and serum albumin. This translated to a 75% higher risk for those in the lowest compared to the highest quartile of relative telomere length. The association was mainly driven by 117 cardiovascular deaths (1.20 [1.05-1.35]) as well as 67 deaths due to infections (1.27 [1.07-1.50]). Thus, our findings support an association of shorter telomere length with all-cause mortality, cardiovascular mortality and death due to infections in patients with moderate chronic kidney disease.