Urinary Biomarkers and Risk of ESRD in the Atherosclerosis Risk in Communities Study

Area of Science:

• Nephrology
• Biomarker Discovery
• Epidemiology

Background:

• Urinary biomarkers like L-FABP, KIM-1, NAG, and NGAL are indicators of tubular injury and potential markers for chronic kidney damage.
• The Atherosclerosis Risk in Communities Study provides a community-based sample for investigating these associations.

Purpose of the Study:

• To evaluate the association between urinary L-FABP, KIM-1, NAG, and NGAL and the incidence of end-stage renal disease (ESRD).

Main Methods:

• A matched case-control study design was employed with 135 ESRD cases and 186 controls.
• Urinary markers (KIM-1/Cr, NAG/Cr, NGAL/Cr, L-FABP/Cr) were measured from baseline urine samples.
• Conditional logistic regression was used to model associations with incident ESRD.

Main Results:

• No significant associations were found for NAG/Cr, NGAL/Cr, or L-FABP/Cr with ESRD.
• Elevated KIM-1/Cr was associated with a higher risk of ESRD in unadjusted and age-adjusted models.
• This association was attenuated after adjusting for baseline kidney function (eGFR and urinary albumin-to-creatinine ratio).
• No association was observed when KIM-1/Cr was analyzed as a continuous variable.

Conclusions:

• Elevated urinary KIM-1/Cr may be linked to an increased risk of incident ESRD.
• KIM-1/Cr did not enhance risk prediction for ESRD when traditional kidney function markers were considered.