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Kidney Week

Abstract: TH-PO991

Gut Microbe-Derived Metabolite Phenylacetylglutamine and Risk of CKD Progression

Session Information

  • Top Trainee Posters - 4
    October 26, 2024 | Location: Exhibit Hall, Convention Center
    Abstract Time: 12:00 PM - 01:00 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.