TY - JOUR
T1 - Urinary biomarkers and risk of ESRD in the atherosclerosis risk in communities study
AU - Foster, Meredith C.
AU - Coresh, Joe
AU - Bonventre, Joseph V.
AU - Sabbisetti, Venkata S.
AU - Waikar, Sushrut S.
AU - Mifflin, Theodore E.
AU - Nelson, Robert G.
AU - Grams, Morgan
AU - Feldman, Harold I.
AU - Vasan, Ramachandran S.
AU - Kimmel, Paul L.
AU - Hsu, Chi Yuan
AU - Liu, Kathleen D.
N1 - Publisher Copyright:
© 2015 by the American Society of Nephrology.
PY - 2015/11/6
Y1 - 2015/11/6
N2 - Background and objectives Liver fatty acid binding protein (L-FABP), kidney injurymolecule 1 (KIM-1),N-acetylb-D-glucosaminidase (NAG), and neutrophil gelatinase-associated lipocalin (NGAL) are urinary markers of tubular injury thatmay also be markers of chronic kidney damage.We evaluated the association of thesemarkers with incident ESRD in a community-based sample from the Atherosclerosis Risk in Communities Study. Design, setting, participants, & measurements This was a matched case-control study of 135 patients with ESRD and 186 controls whowerematched on sex, race, kidney function, and diabetes status at baseline (Atherosclerosis Risk in Communities Study visit 4, 1996-1998). Urinary KIM-1 indexed to creatinine (Cr), NAG/Cr, NGAL/Cr, and L-FABP/Cr were measured in stored spot urine samples from the baseline examination. Associations of KIM-1/Cr,NAG/Cr, andNGAL/Crwith patientswith incident ESRDthrough 2008 weremodeled continuously and categorically (quartiles) using conditional logistic regression. L-FABP/Cr was modeled only categorically because of a large number of measurements below the lower limit of detection for the assay (2.4 ng/ml). Results No significant associations were observed for NAG/Cr, NGAL/Cr, or L-FABP/Cr with ESRD. Those in the highest category for KIM-1/Cr had a higher risk of ESRD compared with those with undetectable biomarker levels (reference group) in unadjusted models (odds ratio, 2.24; 95% confidence interval, 1.97 to 4.69; P=0.03) or adjustment for age (odds ratio, 2.23; 95% confidence interval, 1.06 to 4.67; P=0.03). This association was attenuated with additional adjustment for baseline kidney function (odds ratio, 2.02; 95% confidence interval, 0.95 to 4.31; P=0.07 after additional adjustment for eGFR and natural log of the urinary albumin-to-creatinine ratio). No association between KIM-1/Cr and ESRD was found when KIM-1/Cr was analyzed as a continuous variable. Conclusions Elevated urinary KIM-1/Cr may be associated with a higher risk of incident ESRD, but it does not add to risk prediction after accounting for traditional markers of kidney function in this population.
AB - Background and objectives Liver fatty acid binding protein (L-FABP), kidney injurymolecule 1 (KIM-1),N-acetylb-D-glucosaminidase (NAG), and neutrophil gelatinase-associated lipocalin (NGAL) are urinary markers of tubular injury thatmay also be markers of chronic kidney damage.We evaluated the association of thesemarkers with incident ESRD in a community-based sample from the Atherosclerosis Risk in Communities Study. Design, setting, participants, & measurements This was a matched case-control study of 135 patients with ESRD and 186 controls whowerematched on sex, race, kidney function, and diabetes status at baseline (Atherosclerosis Risk in Communities Study visit 4, 1996-1998). Urinary KIM-1 indexed to creatinine (Cr), NAG/Cr, NGAL/Cr, and L-FABP/Cr were measured in stored spot urine samples from the baseline examination. Associations of KIM-1/Cr,NAG/Cr, andNGAL/Crwith patientswith incident ESRDthrough 2008 weremodeled continuously and categorically (quartiles) using conditional logistic regression. L-FABP/Cr was modeled only categorically because of a large number of measurements below the lower limit of detection for the assay (2.4 ng/ml). Results No significant associations were observed for NAG/Cr, NGAL/Cr, or L-FABP/Cr with ESRD. Those in the highest category for KIM-1/Cr had a higher risk of ESRD compared with those with undetectable biomarker levels (reference group) in unadjusted models (odds ratio, 2.24; 95% confidence interval, 1.97 to 4.69; P=0.03) or adjustment for age (odds ratio, 2.23; 95% confidence interval, 1.06 to 4.67; P=0.03). This association was attenuated with additional adjustment for baseline kidney function (odds ratio, 2.02; 95% confidence interval, 0.95 to 4.31; P=0.07 after additional adjustment for eGFR and natural log of the urinary albumin-to-creatinine ratio). No association between KIM-1/Cr and ESRD was found when KIM-1/Cr was analyzed as a continuous variable. Conclusions Elevated urinary KIM-1/Cr may be associated with a higher risk of incident ESRD, but it does not add to risk prediction after accounting for traditional markers of kidney function in this population.
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U2 - 10.2215/CJN.02590315
DO - 10.2215/CJN.02590315
M3 - Article
C2 - 26350438
AN - SCOPUS:84946751658
SN - 1555-9041
VL - 10
SP - 1956
EP - 1963
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 11
ER -