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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Kidney Tubular Secretion Capacity and Risk of Cardiovascular Mortality in the General Population: The HUNT Study

Alexander L Bullen1,2, Ronit Katz3, Simon B Ascher4,5

  • 1Department of Medicine, Nephrology Section, Veterans Affairs San Diego Healthcare System, La Jolla, California.

Clinical Journal of the American Society of Nephrology : CJASN
|August 20, 2026
PubMed

Insights

Reduced kidney tubular secretion is linked to a higher risk of cardiovascular disease (CVD) mortality in the general population. This association persists even when accounting for kidney function and other risk factors.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Kidney tubular secretion is vital for clearing substances from the body.
  • Reduced tubular secretion is linked to cardiovascular disease (CVD) in advanced chronic kidney disease (CKD).
  • The association between tubular secretion and CVD risk in the general population is not well understood.

Purpose of the Study:

  • To investigate the relationship between kidney tubular secretion and CVD mortality in a general population.
  • To determine if impaired tubular secretion independently predicts CVD mortality.

Main Methods:

  • A case-cohort study design was used, sampling from the Trøndelag Health Study (HUNT-3).
  • A summary secretion score was created based on urine-to-plasma ratios of 12 endogenous solutes.
  • Weighted Cox proportional hazards models analyzed the association between the secretion score and CVD mortality.

Main Results:

  • Lower tubular secretion was associated with a 27% increased risk of CVD mortality per standard deviation decrease in the secretion score.
  • This association remained significant after adjusting for demographics, CVD risk factors, estimated glomerular filtration rate (eGFR), and albuminuria.
  • The findings were consistent across different demographic groups and individuals with or without reduced eGFR or albuminuria.

Conclusions:

  • Impaired kidney tubular secretion is an independent risk factor for CVD mortality in community-dwelling individuals.
  • The study highlights the importance of tubular function beyond just filtration (eGFR) in cardiovascular health.
  • These findings suggest potential therapeutic targets for reducing CVD risk by improving tubular secretion.
Abstract

Keywords:
biomarkerscardiovascular diseasetubule cells

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