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Updated: May 26, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Urinary Biomarkers Of Kidney Function As Predictors Of Cardiovascular Health: A Systematic Review
A Degenaar1, R Kruger1,2, A Jacobs1,2
1Hypertension in Africa Research Team (HART), Private Bag X1290, North-West University, Potchefstroom, 2520, South Africa.
Insights
Urinary kidney function biomarkers like alpha-1 microglobulin (uA1M) and uromodulin (uUMOD) show potential for early cardiovascular risk identification. These biomarkers may help predict adverse cardiovascular outcomes, guiding timely clinical interventions.
Area of Science:
- Nephrology
- Cardiology
- Biomarker Research
Background:
- Cardiovascular diseases (CVD) pose a significant health burden in adults and youth.
- Urinary biomarkers of kidney function offer potential for early detection of CVD risk.
- Identifying individuals at high risk for adverse cardiovascular outcomes is crucial for timely intervention.
Purpose of the Study:
- To systematically review associations between urinary kidney function biomarkers and cardiovascular health measures.
- To assess the utility of biomarkers such as uA1M, uNGAL, uUMOD, and CKD273 in predicting cardiovascular outcomes.
- To evaluate the role of these biomarkers in identifying early signs of cardiovascular risk.
Main Methods:
- Systematic review of studies published between January 2018 and December 2023.
- Searched databases: PubMed, Scopus, and EBSCOhost.
- Included studies examining urinary biomarkers (uA1M, uNGAL, uUMOD, CKD273) and cardiovascular health (blood pressure, target organ damage).
Main Results:
- 1186 articles identified; 22 studies included.
- Alpha-1 microglobulin (uA1M) showed positive associations with office blood pressure and target organ damage markers.
- Uromodulin (uUMOD) demonstrated negative associations with blood pressure.
- Neutrophil gelatinase-associated lipocalin (uNGAL) and CKD273 showed limited or non-significant associations with cardiovascular parameters.
Conclusions:
- Urinary biomarkers of kidney tubule function, specifically uA1M and uUMOD, are relevant to cardiovascular health.
- These biomarkers may aid in early identification of adverse cardiovascular outcomes.
- Further assessment for clinical utilization is recommended for timely cardiovascular risk management.
Purpose Of Review:
The growing burden of cardiovascular diseases has become a significant concern in both adult and youth populations. Urinary biomarkers of kidney function could provide useful insights that may aid in the early identification of individuals at higher risk of adverse cardiovascular outcomes. This systematic review aimed to assess associations between urinary biomarkers of kidney function and different measures of cardiovascular health.
Recent Findings:
PubMed, Scopus, and EBSCOhost were searched for articles published between January 2018 and December 2023. Studies exploring associations between urinary kidney biomarkers (alpha-1 microglobulin (uA1M), neutrophil gelatinase-associated lipocalin (uNGAL), uromodulin (uUMOD) and CKD273 classifier) and measures of cardiovascular health (blood pressure and markers of target organ damage) were included. We identified 1186 articles, with 22 studies eligible for inclusion. Among 12 studies reporting associations between uA1M and measures of cardiovascular health, six studies indicated positive associations with office blood pressure and three studies observed associations with different markers of target organ damage. Out of the nine studies that explored the link between uUMOD and cardiovascular health parameters, four found negative associations between uUMOD and blood pressure. With regard to uNGAL, only two out of the seven studies analysed reported varying associations with blood pressure, while neither of the two studies focusing on CKD273 observed any statistically significant results. Biomarkers of kidney tubule function, represented by uA1M and uUMOD, are relevant in the setting of cardiovascular health and should be assessed for utilisation in clinical practice to identify adverse cardiovascular outcomes at an early stage allowing for timely intervention.
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