We have located links that may give you full text access.
Urinary metabolite profile predicting the progression of chronic kidney disease.
Kidney360. 2023 June 10
BACKGROUND: Since chronic kidney disease (CKD) is caused by genetic and environmental factors, biomarker development through metabolomic analysis, which reflects gene-derived downstream effects and host adaptation to the environment, is warranted.
METHODS: We measured the metabolites in urine samples collected from 789 patients at the time of kidney biopsy and from urine samples from 147 healthy subjects using nuclear magnetic resonance (NMR). The composite outcome was defined as a 30% decline in estimated glomerular filtration rate (eGFR), doubling of serum creatinine levels, or end-stage kidney disease.
RESULTS: Among the 28 candidate metabolites, we identified 7 metabolites showing 1) good discrimination between healthy controls and patients with stage 1 CKD and 2) a consistent change in pattern from controls to patients with advanced-stage CKD. Among the 7 metabolites, betaine, choline, glucose, fumarate, and citrate showed significant associations with the composite outcome after adjustment for age, sex, eGFR, the urine protein-creatinine ratio, and diabetes. Furthermore, adding choline, glucose, or fumarate to traditional biomarkers, including eGFR and proteinuria, significantly improved the ability of the net reclassification improvement (P<0.05) and integrated discrimination improvement (P<0.05) to predict the composite outcome.
CONCLUSION: Urinary metabolites, including betaine, choline, fumarate, citrate, and glucose, were found to be significant predictors of the progression of CKD. As a signature of kidney injury-related metabolites, it would be warranted to monitor to predict the renal outcome.
METHODS: We measured the metabolites in urine samples collected from 789 patients at the time of kidney biopsy and from urine samples from 147 healthy subjects using nuclear magnetic resonance (NMR). The composite outcome was defined as a 30% decline in estimated glomerular filtration rate (eGFR), doubling of serum creatinine levels, or end-stage kidney disease.
RESULTS: Among the 28 candidate metabolites, we identified 7 metabolites showing 1) good discrimination between healthy controls and patients with stage 1 CKD and 2) a consistent change in pattern from controls to patients with advanced-stage CKD. Among the 7 metabolites, betaine, choline, glucose, fumarate, and citrate showed significant associations with the composite outcome after adjustment for age, sex, eGFR, the urine protein-creatinine ratio, and diabetes. Furthermore, adding choline, glucose, or fumarate to traditional biomarkers, including eGFR and proteinuria, significantly improved the ability of the net reclassification improvement (P<0.05) and integrated discrimination improvement (P<0.05) to predict the composite outcome.
CONCLUSION: Urinary metabolites, including betaine, choline, fumarate, citrate, and glucose, were found to be significant predictors of the progression of CKD. As a signature of kidney injury-related metabolites, it would be warranted to monitor to predict the renal outcome.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app