Abstract: SA-PO1109
Association of Biomarkers of Fibrosis with the Progression of CKD
Session Information
- CKD: Epidemiology, Risk Factors, and Prevention - 3
October 26, 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
- Gupta, Jayanta, Florida Gulf Coast University, Fort Myers, Florida, United States
- Srivastava, Anvesha, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
- Amdur, Richard L., Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, United States
- Raj, Dominic S., The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
Background
Fibrosis of the kidney is the hallmark and the final common pathway of chronic kidney disease (CKD) progression, regardless of underlying etiology. Fibrosis is characterized by excessive production and deposition of extracellular matrix (ECM) proteins mainly in the kidney interstitium and results in structural damage, impairment of renal function, and eventually end-stage renal disease (ESRD). The most abundant collagens in the interstitial matrix of the kidney are collagen type I (COL I) and III (COL III). In renal fibrosis, these collagens are upregulated and the activity of the proteases responsible for their remodeling is altered. In this study, we used a sub-cohort of the Chronic Renal Insufficiency Cohort (CRIC) to examine the association of serum PRO-C6, a biomarker for type VI collagen formation and urine C3M, a biomarker for type III collagen degradation with a composite endpoint (ESRD or 50% decline in eGFR).
Methods
Urine C3M was adjusted for 24-hour urinary creatinine excretion. Subjects were categorized into three groups based on tertiles of the biomarker (serum PRO-C6 and urine C3M) levels. The association of biomarkers with the composite outcome was investigated using Kaplan-Meier curves and multivariable Cox proportional hazards regression models after controlling for age, sex, race, income, BMI, diabetes at baseline, hypertension, use of ACEI/ARB, history of CVD, history of smoking, baseline eGFR and UACR.
Results
The number of events in the serum PRO-C6 and urine C3M groups were 426 (out of 998 participants used in the Cox model) and 417 (out of 985 participants used in the Cox model) respectively. The multivariable-adjusted hazard ratios (HRs) comparing the upper to the lower tertiles of serum PRO-C6 and urine C3M for the composite outcome was 1.85 (95% CI: 1.29 - 2.66) and 0.72 (95% CI: 0.56 - 0.94) respectively.
Conclusion
Serum PRO-C6 and urine C3M levels were directly and inversely associated with the composite outcome respectively. These biomarkers may be useful in predicting early events in renal fibrosis.
Funding
- NIDDK Support