Plasma sTWEAK levels in chronic kidney disease stages

Objective: Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) is a cytokine of the TNF superfamily that has a role in injury of different organs including kidney. We hypothesized that in patients with chronic kidney disease (CKD), sTWEAK levels may be related to endothelial dysfunction that usually accompanies the decline of estimated glomerular filtration rate (eGFR). Methods: In 199 patients with different stages of CKD we examined the relationship between sTWEAK plasma levels and CKD stages and the relationship between high sensitivity C reactive protein (hs-CRP), homeostatic model assessment of insulin resistance (HOMA-IR) and sTWEAK concentrations. Results: A gradual decrease in sTWEAK was observed as eGFR decreased. sTWEAK plasma levels were diminished in all stages of CKD and strongly correlated with eGFR. A negative correlation was found between sTWEAK and hs-CRP (p=<0.001) and while a positive correlation was found between sTWEAK and eGFR (p=<0.001). No significant correlation was found between sTWEAK and HOMA-IR. In multivariate regression eGFR, diabetes mellitus and hs-CRP parameters were found to be significant independent variables in decreasing plasma sTWEAK levels. Conclusion: Diminishing of eGFR is accompanied by gradual decreases in sTWEAK plasma levels. Since sTWEAK is strongly and independently correlated with CRP, our study reveals new connections between sTWEAK and endothelial dysfunction in patients with CKD.