Cargando…

Urinary Liver-Type Fatty Acid Binding Protein, a Biomarker for Disease Progression, Dialysis and Overall Mortality in Chronic Kidney Disease

Chronic kidney disease (CKD) is a major public health concern with an increasing proportion of sufferers progressing to renal replacement therapy (RRT). Early identification of those at risk of disease progression could be key in improving outcomes. We hypothesise that urinary liver-type fatty acid...

Descripción completa

Detalles Bibliográficos
Autores principales: Mitsides, Nicos, Mitra, Vikram, Saha, Ananya, Harris, Shelly, Kalra, Philip A., Mitra, Sandip
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10608048/
https://www.ncbi.nlm.nih.gov/pubmed/37888092
http://dx.doi.org/10.3390/jpm13101481
_version_ 1785127687140933632
author Mitsides, Nicos
Mitra, Vikram
Saha, Ananya
Harris, Shelly
Kalra, Philip A.
Mitra, Sandip
author_facet Mitsides, Nicos
Mitra, Vikram
Saha, Ananya
Harris, Shelly
Kalra, Philip A.
Mitra, Sandip
author_sort Mitsides, Nicos
collection PubMed
description Chronic kidney disease (CKD) is a major public health concern with an increasing proportion of sufferers progressing to renal replacement therapy (RRT). Early identification of those at risk of disease progression could be key in improving outcomes. We hypothesise that urinary liver-type fatty acid binding protein (uL-FABP) may be a suitable biomarker for CKD progression and can add value to currently established biomarkers such as the urinary protein-to-creatinine ratio (uPCR). A total of 583 participants with CKD 1–5 (not receiving renal replacement therapy) entered a 2 yr prospective longitudinal study. UPCR and uL-FABP were measured at baseline and CKD progression was defined as either (i) a decline in eGFR of >5 mL/min/1.73 m(2) or an increase in serum creatinine by 10% at 1 yr; (ii) a decline in eGFR of >6 mL/min/1.73 m(2) or an increase in serum creatinine by 20% at 2 yrs; or (iii) the initiation of RRT. A combined outcome of initiating RRT or death was also included. Approximately 40% of participants showed CKD progression. uL-FABP predicted CKD progression at both years 1 and 2 (OR 1.01, p < 0.01). Sensitivity and specificity were comparable to those of uPCR (AUC 0.623 v 0.706) and heat map analysis suggested that uL-FABP in the absence of significant proteinuria can predict an increase in serum creatinine of 10% at 1 yr and 20% at 2 yrs. The risk of the combined outcome of initiating RRT or death was 23% higher in those with high uL-FABP (p < 0.01) independent of uPCR. uL-FABP appears to be a highly sensitive and specific biomarker of CKD progression. The use of this biomarker could enhance the risk stratification of CKD and its progression and should be assessed further.
format Online
Article
Text
id pubmed-10608048
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-106080482023-10-28 Urinary Liver-Type Fatty Acid Binding Protein, a Biomarker for Disease Progression, Dialysis and Overall Mortality in Chronic Kidney Disease Mitsides, Nicos Mitra, Vikram Saha, Ananya Harris, Shelly Kalra, Philip A. Mitra, Sandip J Pers Med Article Chronic kidney disease (CKD) is a major public health concern with an increasing proportion of sufferers progressing to renal replacement therapy (RRT). Early identification of those at risk of disease progression could be key in improving outcomes. We hypothesise that urinary liver-type fatty acid binding protein (uL-FABP) may be a suitable biomarker for CKD progression and can add value to currently established biomarkers such as the urinary protein-to-creatinine ratio (uPCR). A total of 583 participants with CKD 1–5 (not receiving renal replacement therapy) entered a 2 yr prospective longitudinal study. UPCR and uL-FABP were measured at baseline and CKD progression was defined as either (i) a decline in eGFR of >5 mL/min/1.73 m(2) or an increase in serum creatinine by 10% at 1 yr; (ii) a decline in eGFR of >6 mL/min/1.73 m(2) or an increase in serum creatinine by 20% at 2 yrs; or (iii) the initiation of RRT. A combined outcome of initiating RRT or death was also included. Approximately 40% of participants showed CKD progression. uL-FABP predicted CKD progression at both years 1 and 2 (OR 1.01, p < 0.01). Sensitivity and specificity were comparable to those of uPCR (AUC 0.623 v 0.706) and heat map analysis suggested that uL-FABP in the absence of significant proteinuria can predict an increase in serum creatinine of 10% at 1 yr and 20% at 2 yrs. The risk of the combined outcome of initiating RRT or death was 23% higher in those with high uL-FABP (p < 0.01) independent of uPCR. uL-FABP appears to be a highly sensitive and specific biomarker of CKD progression. The use of this biomarker could enhance the risk stratification of CKD and its progression and should be assessed further. MDPI 2023-10-11 /pmc/articles/PMC10608048/ /pubmed/37888092 http://dx.doi.org/10.3390/jpm13101481 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mitsides, Nicos
Mitra, Vikram
Saha, Ananya
Harris, Shelly
Kalra, Philip A.
Mitra, Sandip
Urinary Liver-Type Fatty Acid Binding Protein, a Biomarker for Disease Progression, Dialysis and Overall Mortality in Chronic Kidney Disease
title Urinary Liver-Type Fatty Acid Binding Protein, a Biomarker for Disease Progression, Dialysis and Overall Mortality in Chronic Kidney Disease
title_full Urinary Liver-Type Fatty Acid Binding Protein, a Biomarker for Disease Progression, Dialysis and Overall Mortality in Chronic Kidney Disease
title_fullStr Urinary Liver-Type Fatty Acid Binding Protein, a Biomarker for Disease Progression, Dialysis and Overall Mortality in Chronic Kidney Disease
title_full_unstemmed Urinary Liver-Type Fatty Acid Binding Protein, a Biomarker for Disease Progression, Dialysis and Overall Mortality in Chronic Kidney Disease
title_short Urinary Liver-Type Fatty Acid Binding Protein, a Biomarker for Disease Progression, Dialysis and Overall Mortality in Chronic Kidney Disease
title_sort urinary liver-type fatty acid binding protein, a biomarker for disease progression, dialysis and overall mortality in chronic kidney disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10608048/
https://www.ncbi.nlm.nih.gov/pubmed/37888092
http://dx.doi.org/10.3390/jpm13101481
work_keys_str_mv AT mitsidesnicos urinarylivertypefattyacidbindingproteinabiomarkerfordiseaseprogressiondialysisandoverallmortalityinchronickidneydisease
AT mitravikram urinarylivertypefattyacidbindingproteinabiomarkerfordiseaseprogressiondialysisandoverallmortalityinchronickidneydisease
AT sahaananya urinarylivertypefattyacidbindingproteinabiomarkerfordiseaseprogressiondialysisandoverallmortalityinchronickidneydisease
AT harrisshelly urinarylivertypefattyacidbindingproteinabiomarkerfordiseaseprogressiondialysisandoverallmortalityinchronickidneydisease
AT kalraphilipa urinarylivertypefattyacidbindingproteinabiomarkerfordiseaseprogressiondialysisandoverallmortalityinchronickidneydisease
AT mitrasandip urinarylivertypefattyacidbindingproteinabiomarkerfordiseaseprogressiondialysisandoverallmortalityinchronickidneydisease