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Kidney Week

Abstract: SA-PO794

Significant Urinary Metabolites in the Progression of CKD

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Kim, Yaerim, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lee, Jueun, Korea Basic Science Intsitute, Seoul, Korea (the Republic of)
  • Hwang, Geum-Sook, Korea Basic Science Intsitute, Seoul, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)
Background

Despite the development of diagnostic techniques, methods for predicting changes in renal function or outcomes are still insufficient. Metabolomics is considered to be a breakthrough method to address the shortage of tools by analyzing the end metabolites, reflecting genetic and environmental factors. Herein, we would like to propose the metabolites which significantly associated with development and progression of chronic kidney disease (CKD).

Methods

We measured urinary metabolites from 1,274 urine samples at the time of renal biopsy and 147 urine samples from healthy subjects using nuclear magnetic resonance. The clinical outcome was defined as a decrease in estimated glomerular filtration 30%, doubling of serum creatinine, or development of end-stage renal disease.

Results

Initial partial components analysis and partial least squares-discriminant analysis score plots showed discriminated cluster between CKD and control, and according to the stage of CKD. A total of 41 metabolites confirmed to candidate marker associated with CKD. Six of metabolites (betaine, glycine, glycerol, trimethylamine-N-oxide, taurine, choline) showed increasing pattern, and 6 of metabolites (1-methylnicotinamide, formate, hypoxanthine, ethanolamine, citrate, 3-hydroxyisovalerate) showed decreasing trend to the stage of CKD. A total of 14 metabolites (phenylalanine, fumarate, betaine, glycine, glycerol, taurine, trimethylamine-N-oxide, betaine, choline, acetoacetate, acetone, acetate, isoleucine, leucine) had significantly increased hazard ratio to composite outcomes, and four metabolites (fumarate, betaine, taurine, choline) showed higher hazard ratio to outcome of creatinine doubling. In survival analysis using the median value of each metabolite, the cumulative incidence of clinical outcomes was significantly increased in 19 metabolites and decreased in 4 metabolites.

Conclusion

Metabolites which inform the disease progression or development can be a noble biomarker. In our study, betaine, choline, taurine, trimethylamine-N-oxide, glycine, and glycerol were shown to be a significant predictor in the progression of CKD. Although additional study for validation should be performed, we could find significant metabolites associate with CKD. And these results could be an instrumental keynote to moving ahead.