Copeptin as a Biomarker in Chronic Kidney Disease-A Systematic Review and Meta-Analysis

Background: Numerous studies have explored the potential of the biomarker copeptin (CPP) in diagnosing and assessing the severity of chronic kidney disease (CKD). Despite these efforts, findings have been inconsistent. Consequently, this study aimed to examine the association between CPP and CKD, specifically evaluating its diagnostic value and correlation with CKD severity as classified by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Methods: A systematic search of PubMed, EMBASE, and Scopus was conducted using a predefined search string to identify relevant studies. Eligible studies included those involving CKD patients classified by glomerular filtration rate (GFR) according to the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines or by the estimated GFR (eGFR) calculated using the MDRD formula, provided they met predefined inclusion criteria. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). The primary outcome measured was the mean difference (MD) in serum CPP levels across the various stages of CKD. Results: A total of seven studies, comprising 2769 participants, met the inclusion criteria and were incorporated into our systematic review and meta-analysis. Notable differences in CPP levels were identified across various comparisons. Specifically, CPP levels were significantly elevated in CKD patients compared to healthy controls, with a mean difference (MD) of 12.975 (95% CI 6.572, 19.379). Additional significant MDs were observed in comparisons including controls versus CKD stages 1-2/2 (-1.600 [95% CI -3.179, -0.020]), controls versus CKD stage 3 (-9.598 [95% CI -12.959,-6.237]), controls versus CKD stages 4-5 (-28.776 [95% CI -42.925, -14.628]), and CKD stages 1-2 versus stages 4-5 (-30.475 [95% CI -46.790, -14.160]). Conclusions: Comparison between the CKD patients and healthy controls revealed significantly elevated CPP levels, suggesting a possible role in renal pathology. Furthermore, the distinct differences in CPP concentrations across various CKD stages highlight its potential as a biomarker for assessing disease severity and progression.