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Related Experiment Video

Updated: Jan 7, 2026

Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies
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Biomarkers.

Joshua A Bornhorst1, Chelsea Swartchick1, Prashanthi Vemuri2

  • 1Mayo Clinic, Rochester, MN, USA.

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Summary

Adjusting Alzheimer's disease (AD) biomarker measurements for chronic kidney disease (CKD) is crucial. Using the %p-tau217 or p-tau217/Aβ42 ratio minimizes confounding effects from decreased kidney function.

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Area of Science:

  • Neurology and Nephrology
  • Biomarker Discovery and Validation

Background:

  • Chronic kidney disease (CKD) elevates blood biomarker concentrations, potentially impacting Alzheimer's disease (AD) diagnostics.
  • Plasma phosphorylated tau217 (p-tau217) increases with AD pathology, while amyloid beta 1-42 (Aβ42) decreases.
  • The influence of reduced estimated glomerular filtration rate (eGFR) on these biomarkers in non-amyloid individuals requires investigation.

Purpose of the Study:

  • To assess the association between plasma biomarkers (p-tau217, np-tau217, Aβ42, Aβ40, and their ratios) and decreased eGFR.
  • To determine if specific biomarker ratios can mitigate confounding effects of reduced kidney function on AD biomarker measurements.

Main Methods:

  • Study included participants with CKD stages 1-4 (eGFR 25-98) confirmed amyloid-PET negative.
  • Plasma biomarkers were quantified using immunoprecipitation mass spectrometry.
  • Regression analysis modeled the impact of eGFR changes on individual biomarkers and calculated ratios (%p-tau217, Aβ42/Aβ40, p-tau217/Aβ42).

Main Results:

  • Decreasing eGFR significantly increased predicted plasma p-tau217 (52%), Aβ42 (16%), and Aβ40 (19%).
  • The p-tau217/Aβ42 ratio and %p-tau217 showed smaller predicted increases (31% and 19%, respectively) with decreasing eGFR.
  • The Aβ42/Aβ40 ratio did not show a predicted increase, suggesting it is less affected by eGFR changes.

Conclusions:

  • The %p-tau217 and, to a lesser extent, the p-tau217/Aβ42 ratio effectively reduce confounding from decreased eGFR compared to p-tau217 alone.
  • Aβ42 and Aβ40 also showed reduced predicted increases with decreasing eGFR relative to p-tau217.
  • These adjusted ratios offer improved utility for AD biomarker assessment in individuals with impaired kidney function.