Kidney Week

Abstract: SA-PO1171

Associations of Urine Epidermal Growth Factor with Kidney and Cardiovascular Outcomes in Individuals with CKD in SPRINT

Session Information

• CKD: Mechanisms - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2303 CKD (Non-Dialysis): Mechanisms

Authors

• Postalcioglu, Merve, UCSF Medical Center, San Francisco, California, United States

Merve Postalcioglu, MD

• Katz, Ronit, University of Washington, Seattle, Washington, United States

Ronit Katz, PhD

• Ascher, Simon, University of California Davis, Davis, California, United States

Simon Ascher, MD, MPH

• Garimella, Pranav S., University of California San Diego, La Jolla, California, United States

Pranav S. Garimella, MD, MPH, FASN

• Hallan, Stein I., St Olav's Hospital HF, Trondheim, Trøndelag, Norway

Stein I. Hallan, MD, PhD

• Ix, Joachim H., University of California San Diego, La Jolla, California, United States

Joachim H. Ix, MD, FASN

• Shlipak, Michael, UCSF Medical Center, San Francisco, California, United States

Michael Shlipak, MD, MPH

Background

Urine epidermal growth factor (uEGF) marks kidney tubule function and lower urine concentrations are associated with faster kidney function loss. Its associations with cardiovascular disease (CVD) and mortality are unknown.

Methods

We measured uEGF among 2,346 Systolic Blood Pressure Intervention Trial (SPRINT) participants with an eGFR<60 ml/min/1.73m². Linear mixed-effects models were used to investigate associations with the annual eGFR change, and Cox models evaluated associations with the ≥30% eGFR decline, cardiovascular disease (CVD), and mortality. To account for the competing risk of death, Fine and Gray method was utilized for acute kidney injury (AKI) and end-stage kidney disease (ESKD) outcomes.

Results

Mean (SD) age was 73±9 years, mean eGFR was 46±11 ml/min/1.73m² and median UACR of 15 mg/g (interquartile range: 7-49). In analyses adjusting for baseline albuminuria and eGFR, each 50% lower uEGF concentration was associated with 0.74% (95% confidence interval:1.19, 0.29) per year faster decline in eGFR. (Table) During 3.1 (median) years of follow-up, lower uEGF was also associated with higher risk of ≥30% eGFR decline. Lower uEGF concentrations were associated with ESKD, AKI, incident CVD, and mortality in initial models, but associations were substantially attenuated by adjustment for albuminuria and eGFR. (Table)

Conclusion

Among hypertensive adults with CKD, lower uEGF is associated with faster eGFR decline independent of baseline albuminuria and eGFR; but not with ESKD, AKI, CVD, or mortality.

Funding

• NIDDK Support