Abstract: TH-PO991
Gut Microbe-Derived Metabolite Phenylacetylglutamine and Risk of CKD Progression
Session Information
- CKD: Epidemiology, Risk Factors, and Prevention - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Cheng, Evelyn, University of Washington, Seattle, Washington, United States
- Lin, Ting-yun, Taipei Tzu Chi Hospital, Taipei, Taiwan
- Hung, Szu-Chun, Taipei Tzu Chi Hospital, Taipei, Taiwan
Background
Phenylacetylglutamine (PAG) is a gut microbe-derived metabolite from dietary phenylalanine. High PAG levels have been associated with overall mortality and cardiovascular disease in patients with CKD. However, potential associations of PAG with the risk of progression to kidney failure in patients with CKD remains unclear.
Methods
We prospectively followed 152 non-dialysis patients with CKD stages 3–5 and a measurement of plasma PAG. The primary outcome was a composite of progression of kidney disease (defined as a sustained decrease in eGFR of ≥40% from baseline, initiation of maintenance dialysis, kidney transplantation, or death from renal causes).
Results
Participants had a mean age of 66 years; 41.4% were women; 39.5% had diabetes; and the median eGFR was 23 mL/min/1.73 m2. Participants with higher PAG were more likely to have a significantly lower eGFR (P <0.001). During a median follow-up of 3.3 years, progression of kidney disease occurred in 76 (50%) participants. Higher PAG was associated with a significantly increased risk of the composite outcome after controlling for demographics, comorbidities, and proteinuria (hazard ratio, 1.79; 95% CI, 1.27–2.54). However, the association was attenuated and statistically insignificant after adjustment for eGFR.
Conclusion
Our findings suggest the relevance of PAG in the progression of kidney disease. Whether PAG is simply a marker of kidney dysfunction or, in contrast, whether PAG actively alters the course of CKD needs to be investigated.
PAG and CKD progression. Kaplan–Meier survival curve. Quartiles of serum PAG.
Cox proportional hazard survival analysis