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DK007777-13"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Uromodulin (UMOD) is released by renal tubular cells into the serum (sUMOD) and urine. Lower urine UMOD has been linked to mortality and cardiovascular disease but much less is known about sUMOD. We evaluated the association of sUMOD with these outcomes in community-dwelling older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We measured sUMOD in a random subcohort of 933 participants enrolled in the Cardiovascular Health Study. The associations of sUMOD with all-cause mortality, incident heart failure (HF) and incident cardiovascular disease (CVD; myocardial infarction, stroke and mortality due to coronary disease or stroke) were evaluated using multivariable Cox regression, adjusting for study participants\u2019 demographics, estimated glomerular filtration rate (eGFR), albuminuria and CVD risk factors. Generalized additive models with splines were used to address the functional form of sUMOD with outcomes. Due to nonlinear associations of sUMOD with all outcomes, 2.5% of the values on either end of the sUMOD distribution were excluded from the analyses, limiting the range of sUMOD to 34.3\u2013267.1\u2009ng\/mL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean age was 78\u2009\u00b1\u20095\u2009years, 40% were male, sUMOD level was 127\u2009\u00b1\u200964\u2009ng\/mL, eGFR was 63\u2009mL\/min\/1.73\u00a0m2 and 42% had CKD defined as eGFR\u2009&amp;lt;60\u2009mL\/min\/1.73\u00a0m2. Patients in the lower sUMOD quartiles had lower eGFR and higher albuminuria (P\u2009&amp;lt;\u20090.01, respectively). During a median follow-up of 9.9\u2009years, 805 patients died, 283 developed HF and 274 developed CVD. In multivariable analysis, higher sUMOD was significantly associated with a lower hazard for mortality {hazard ratio [HR] 0.89 [95% confidence interval (CI) 0.80\u20130.99] per 1 standard deviation (SD) higher sUMOD}, CVD [HR 0.80 (95% CI 0.67\u20130.96)] and the composite endpoint [HR 0.88 (95% CI 0.78\u20130.99)]; the association with HF was not statistically significant [HR 0.84 (95% CI 0.70\u20131.01)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher sUMOD is independently associated with a lower risk for mortality and CVD in older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfz008","type":"journal-article","created":{"date-parts":[[2019,1,9]],"date-time":"2019-01-09T23:19:44Z","timestamp":1547075984000},"page":"1399-1405","source":"Crossref","is-referenced-by-count":30,"title":["Association of serum uromodulin with mortality and cardiovascular disease in the elderly\u2014the Cardiovascular Health Study"],"prefix":"10.1093","volume":"35","author":[{"given":"Dominik","family":"Steubl","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Tufts Medical Center, Tufts University, Boston, MA, USA"},{"name":"Division of Nephrology, Klinikum rechts der Isar, Technische Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Buzkova","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranav S","family":"Garimella","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of California, San Diego, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim H","family":"Ix","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of California, San Diego, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasad","family":"Devarajan","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Cincinnati Children\u2019s Hospital, University of Cincinnati, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Cincinnati Children\u2019s Hospital, University of Cincinnati, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo H M","family":"Chaves","sequence":"additional","affiliation":[{"name":"Benjamin Leon Center for Geriatric Research and Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 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