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A better understanding of the factors contributing to the high mortality may help design novel monitoring and therapeutic approaches, since protection offered by statins in CKD patients is not satisfactory. Proprotein Convertase Subtilisin\/Kexin Type 9 (PCSK9) promotes hypercholesterolemia and may be targeted therapeutically. Adding anti\u2010PCSK9 agents to standard lipid lowering therapy further reduces the incidence of cardiovascular events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We studied plasma PCSK9 in a cross\u2010sectional study of 134 diabetic kidney disease patients with estimated glomerular filtration rate (eGFR) categories G1\u2010G4 and albuminuria categories A1\u2010A3, in order to identify factors influencing plasma PCSK9 in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean\u00b1SD plasma PCSK9 levels were 309.8\u00b1113.9 ng\/ml. Plasma PCSK9 was not influenced by eGFR or albuminuria, but was higher in patients on lipid lowering therapy. In univariate analysis, plasma PCSK9 showed a significant positive correlation with serum total iron binding capacity, vitamin E, plasma renin and phosphaturia, and there was a trend towards a positive correlation with total serum cholesterol. In multivariate models, only therapy with fibrate and statin, and renin remained independently correlated with plasma PCSK9. However, multivariate models explained very little of the PCSK9 variability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In DKD, therapy with lipid lowering drugs and specially the fibrate\/statin combination were independently associated with higher PCSK9 levels. The biomarker potential of PCSK9 levels to identify DKD patients that may benefit from anti\u2010PCSK9 strategies should be studied.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.12661","type":"journal-article","created":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T15:02:48Z","timestamp":1469026968000},"page":"779-786","source":"Crossref","is-referenced-by-count":30,"title":["<scp>PCSK<\/scp>9 in diabetic kidney disease"],"prefix":"10.1111","volume":"46","author":[{"given":"Usama","family":"Elewa","sequence":"first","affiliation":[{"name":"IIS\u2010Fundaci\u00f3n Jim\u00e9nez D\u00edaz School of Medicine Universidad Aut\u00f3noma de Madrid Madrid Spain"},{"name":"Fundaci\u00f3n Renal I\u00f1igo Alvarez de Toledo\u2010IRSIN Madrid Spain"},{"name":"REDINREN Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Fern\u00e1ndez\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"IIS\u2010Fundaci\u00f3n Jim\u00e9nez D\u00edaz 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