High Levels of Galectin-3 and Uric Acid Are Independent Predictors of Renal Impairment in Patients with Stable Coronary Artery Disease.

Background: High plasma levels of Galectin-3 (Gal-3) and uric acid (UA) are associated with a decline in renal function in different populations. However, this association has not yet been studied in patients with coronary artery disease (CAD). Methods: We included 556 patients with stable CAD. Plasma levels of Gal-3, UA, N-Terminal probrain natriuretic peptide (NT-proBNP), calcidiol, fibroblast growth factor 23, phosphate, parathormone, and klotho were assessed at baseline. The primary outcome was the percentage decrease in eGFR; the secondary outcomes were the absolute decrease in eGFR and achieving a reduction of ≥20% in this parameter. Results: Age was 63.1 ± 12.2 years, and 73.9% of patients were male. The median eGFR was 86.77 (72.27, 97.85) mL/min/1.73 m(2). After 3.47 (2.10-5.72) years of follow-up, eGFR declined by 3.62% [-2.07-13.82]. Baseline UA (0.012 [CI95% 0.003, 0.020]; p = 0.008), Gal-3 (0.0153 [CI95% 0.001, 0.029]; p = 0.037), and NT-proBNP (0.017 [CI95% 0.000-0.025]; p = 0.027) were independent positive predictors of the percentage decrease in eGFR, while calcidiol (-0.005 [CI95% -0.009, -0.002]; p = 0.005) was an inverse predictor of this outcome. Similarly, UA and Gal-3 were positive independent predictors of the absolute decline in eGFR (0.009 [0.003, 0.017]; p = 0.004 and 0.012 [0.001, 0.023]; p = 0.031, respectively), while calcidiol was inversely associated (-0.003 [-0.005]-[-0.001]; p = 0.020). Uric acid (1.237 [1.046-1.463]; p = 0.013) and NT-proBNP (1.000 [1.000-1.001]; p = 0.049) levels were positive independent predictors of a ≥20% decrease in eGFR. In patients with eGFR ≥ 60 mL/min/1.73 m(2), UA was the only biomarker independently associated with renal function decline. Conclusions: In patients with CAD and normal or mildly reduced renal function, UA and Gal-3 plasma levels are independent positive predictors of a future decrease in eGFR. These findings could lead to a change in the approach to patients with CAD in the future.