Diagnosis and Prediction of CKD Progression by Assessment of Urinary Peptides

Progressive CKD is generally detected at a late stage by a sustained decline in eGFR and/or the presence of significant albuminuria. With the aim of early and improved risk stratification of patients with CKD, we studied urinary peptides in a large cross-sectional multicenter cohort of 1990 individu...

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Published in:Journal of the American Society of Nephrology 2015-08, Vol.26 (8), p.1999-2010
Main Authors: Schanstra, Joost P, Zürbig, Petra, Alkhalaf, Alaa, Argiles, Angel, Bakker, Stephan J L, Beige, Joachim, Bilo, Henk J G, Chatzikyrkou, Christos, Dakna, Mohammed, Dawson, Jesse, Delles, Christian, Haller, Hermann, Haubitz, Marion, Husi, Holger, Jankowski, Joachim, Jerums, George, Kleefstra, Nanne, Kuznetsova, Tatiana, Maahs, David M, Menne, Jan, Mullen, William, Ortiz, Alberto, Persson, Frederik, Rossing, Peter, Ruggenenti, Piero, Rychlik, Ivan, Serra, Andreas L, Siwy, Justyna, Snell-Bergeon, Janet, Spasovski, Goce, Staessen, Jan A, Vlahou, Antonia, Mischak, Harald, Vanholder, Raymond
Format: Article
Language:English
Subjects:
Adult
Aged
Biomarkers - urine
Clinical Research
Cohort Studies
Disease Progression
Female
Glomerular Filtration Rate
Humans
Life Sciences
Male
Middle Aged
Peptides - urine
Renal Insufficiency, Chronic - urine
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Summary:Progressive CKD is generally detected at a late stage by a sustained decline in eGFR and/or the presence of significant albuminuria. With the aim of early and improved risk stratification of patients with CKD, we studied urinary peptides in a large cross-sectional multicenter cohort of 1990 individuals, including 522 with follow-up data, using proteome analysis. We validated that a previously established multipeptide urinary biomarker classifier performed significantly better in detecting and predicting progression of CKD than the current clinical standard, urinary albumin. The classifier was also more sensitive for identifying patients with rapidly progressing CKD. Compared with the combination of baseline eGFR and albuminuria (area under the curve [AUC]=0.758), the addition of the multipeptide biomarker classifier significantly improved CKD risk prediction (AUC=0.831) as assessed by the net reclassification index (0.303±-0.065; P
ISSN:1046-6673
1533-3450
DOI:10.1681/asn.2014050423