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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

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Biomarkers of Kidney Failure and All-Cause Mortality in CKD

Anthony Onoja1, Thomas McDonnell2,3, Isabelle Annessi4

  • 1Faculty of Health and Medical Sciences, School of Health Sciences, University of Surrey, Guildford, United Kingdom.

Journal of the American Society of Nephrology : JASN
|June 20, 2025
PubMed

Insights

Novel biomarkers show promise in predicting chronic kidney disease (CKD) outcomes. While established factors remain strong predictors, new biomarkers offer comparable or improved risk assessment for kidney failure and mortality.

Area of Science:

  • Nephrology
  • Biomarker Discovery
  • Risk Prediction Modeling

Background:

  • Chronic kidney disease (CKD) necessitates personalized risk assessment due to variable adverse outcomes.
  • Novel biomarkers targeting kidney damage, fibrosis, inflammation, and cardiovascular disease mechanisms were evaluated.

Purpose of the Study:

  • To assess the predictive value of novel biomarkers for kidney failure, all-cause mortality, and a composite outcome in CKD patients.
  • To compare the performance of biomarker-based risk models against established risk factors.

Main Methods:

  • Analysis of 21 biomarkers in urine, plasma, or serum from 2,884 non-dialysis CKD patients across 16 UK nephrology centers.
  • Utilized Cox proportional hazards models to develop and evaluate risk prediction models.

Main Results:

  • For kidney failure, established risk factors (eGFR, UACR, age, sex, ethnicity) showed superior discrimination (c-index 0.90) compared to a three-biomarker model (c-index 0.86).
  • For all-cause mortality, a three-biomarker model (hs-cTnT, NT-proBNP, suPAR) demonstrated equivalent discrimination (c-index 0.80) to established risk factors.
  • For the composite outcome, adding biomarkers to established risk factors provided a small but significant improvement in discrimination (c-index 0.80 vs 0.77).

Conclusions:

  • Risk prediction models incorporating novel biomarkers demonstrate comparable discrimination to established risk factors for kidney failure and all-cause mortality.
  • Novel biomarkers may enhance risk stratification for composite outcomes in CKD when used alongside traditional factors.
Abstract

No abstract available in PubMed .

Keywords:
CKDCKD non-dialysisESKDbiomarkerskidney failuremortalitymortality riskprogressionprogression of renal failuresurvival analysis

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