Abstract: SA-PO316
Urinary Growth Differentiation Factor 15 May Be a New Biomarker of Kidney Failure Progression in Diabetic Kidney Disease
Session Information
- Diabetic Kidney Disease: Clinical Pathology, Diagnostic and Treatment Advances
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Watanabe, Shun, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Toyohara, Takafumi, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Kikuchi, Koichi, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Suzuki, Takehiro, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Wada, Jun, Okayama University Graduate School of Medicine, Sendai, Miyagi, Japan
- Tanaka, Tetsuhiro, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Abe, Takaaki, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
Background
Sensitive biomarkers can enhance the diagnosis, prognosis, and surveillance of chronic kidney disease (CKD), including diabetic kidney disease (DKD). Plasma growth differentiation factor 15 (GDF15) levels are a novel biomarker for mitochondria-associated diseases. However, plasma GDF15 levels increase with declining renal function, which may limit its utility in CKD. This study explores the potential of urinary GDF15 as a marker for CKD progression.
Methods
Plasma and urinary GDF15, along with 15 uremic toxins, were measured in 103 CKD patients. The relationship between the urinary GDF15-creatinine ratio and uremic toxins, as well as other clinical characteristics, was investigated. Furthermore, the relationship between the urinary GDF15-creatinine ratio and renal failure progression was examined. The urinary biomarker for the continuous and rapid progression of diabetic nephropathy (U-CARE) study was a multicenter, observational clinical study aimed at investigating urinary biomarkers in diabetic nephropathy (UMIN 00011525). Data from 342 patients in U-CARE study were used to evaluate the performance of the urinary GDF15-creatinine ratio as a biomarker for renal failure progression.
Results
Urinary GDF15-creatinine ratios were less related to renal function and uremic toxin levels compared to plasma GDF15 (eGFR and plasma GDF15 r = -0.46, p < 0.01, eGFR and urinary GDF15 r = 0.13, p = 0.19). However, higher urinary GDF15 levels were observed in patients with worsening renal function. In the U-CARE cohort (n = 342), multiple and logistic regression analyses revealed that baseline urinary GDF15-creatinine ratios predicted a decline in estimated glomerular filtration rate (eGFR) over 2 years (multiple regression: p = 0.03, logistic regression: p = 0.05), suggesting a predictive ability comparable to the existing urinary albumin-creatinine ratio.
Conclusion
Urinary GDF15 may serve as a useful prognostic marker for renal failure progression in patients with DKD, similar to the urine albumin-creatinine ratio. Integrating this marker into clinical practice could facilitate early therapeutic intervention for patients with progressing renal failure.