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Homocitrulline Is Associated with Cardiovascular Outcomes in Nondialysis Patients with CKD
Solène M Laville1,2, Stéphane Jaisson3, Philippe Gillery3
1MP3CV Laboratory, Jules Verne University of Picardie, Amiens, France.
Kidney360
|April 1, 2025
Insights
Higher homocitrulline (HCit) levels in chronic kidney disease (CKD) patients are linked to increased cardiovascular events and mortality. This study highlights HCit as a potential biomarker for adverse outcomes in CKD.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Biochemistry
Background:
- Protein carbamylation, indicated by homocitrulline (HCit), elevates cardiovascular risk, particularly in chronic kidney disease (CKD) patients with high urea.
- HCit serves as a biomarker for overall protein carbamylation.
Purpose of the Study:
- To investigate the association between serum HCit concentration and adverse cardiovascular outcomes and all-cause mortality in non-dialysis CKD patients.
- To determine if HCit levels predict major adverse cardiovascular events (MACE) and death before kidney replacement therapy (KRT).
Main Methods:
- A prospective cohort study (CKD-REIN) included 2,195 CKD patients (eGFR <60mL/min/1.73m2).
- Serum HCit was measured at baseline and patients were grouped into tertiles.
- Adjusted Cox proportional hazards models analyzed risks for MACE and death before KRT.
Main Results:
- Serum HCit concentration correlated with decreased eGFR and increased urea levels.
- Higher HCit tertiles (T2 and T3) were independently associated with increased risk of MACE compared to the lowest tertile (T1).
- Elevated HCit levels significantly increased the risk of death before KRT.
Conclusions:
- Serum HCit concentration is associated with a higher likelihood of MACE and death in CKD patients.
- Further research into therapeutic interventions to reduce carbamylation is warranted to confirm causality.
Abstract
No abstract available in PubMed .
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