Associations between neurofilament light chain protein, brain structure and chronic kidney disease

BACKGROUND: Neurofilament light chain (NfL) protein is a blood-based marker of neuroaxonal injury. We sought to 1) compare plasma NfL levels in children with chronic kidney disease (CKD) and healthy peers, 2) characterize the relationship between NfL level and kidney function, and 3) evaluate NfL as a predictor of abnormal brain structure in CKD. METHODS: Sixteen children with CKD due to congenital kidney anomalies and 23 typically developing peers were included. Plasma NfL was quantified using single-molecule array immunoassay. Participants underwent structural magnetic resonance imaging. Multiple linear regression models were used to evaluate the association between plasma NfL levels, kidney function, and brain structure. RESULTS: An age × group interaction was identified whereby NfL levels increased with age in the CKD group only (estimate = 0.65; CI = 0.08–1.22; p = 0.026). Decreased kidney function was associated with higher NfL levels (estimate = −0.10; CI = −0.16 to −0.04; p = 0.003). Lower cerebellar gray matter volume predicted increased plasma NfL levels (estimate = −0.00024; CI = −0.00039–0.00009; p = 0.004) within the CKD group. CONCLUSION: Children with CKD show accelerated age-related increase in NfL levels. NfL level is associated with lower kidney function and abnormal brain structure in CKD.