Abstract: FR-PO533

Uromodulin and Risk of Infection Related Hospitalizations

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Garimella, Pranav S., University of california san diego, San Diego, California, United States
  • Buzkova, Petra, UW, Seattle, Washington, United States
  • Ix, Joachim H., UCSD, San Diego, California, United States
  • El-Achkar, Tarek M., Indiana University , Indianapolis, Indiana, United States
  • Devarajan, Prasad, Cincinnati Children's Hospital, Cincinnati, Ohio, United States
  • Bennett, Michael R., Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Shlipak, Michael, San Francisco VA Medical Center, San Francisco, California, United States
  • Sarnak, Mark J., Tufts Medical Center, Boston, Massachusetts, United States
Background

Higher uromodulin levels are associated with lower rates of urinary tract infections in humans, and laboratory studies indicate that uromodulin may also be beneficial in sepsis and bacteremia. Studies have not confirmed the association between uromodulin and risk of all-cause infections in humans.

Methods

Using data from a random, sub-cohort of 958 older adults enrolled in the Cardiovascular Health Study, we evaluated whether spot urine uromodulin levels are associated with risk of infectious hospitalizations using Poisson and Cox regression analysis with several nested models.

Results

The mean age of participants was 78.1 years, mean eGFR was 70.9 ml/min/1.73m2 and 39.5% were men. The median (IQR) urinary uromodulin level was 25.88 (17.25, 38.83) units. There were 592 infections hospitalizations among 362 participants during a median follow up of 9.2 years. Rates of hospitalizations (per100 person-years) decreased across higher quartiles of uromodulin: 7.4, 6.0, 5.8, and 5.6. Each doubling of uromodulin was associated with 20% lower number of infectious hospitalizations (Rate Ratio 0.80, 95% CI 0.66, 0.97) when adjusted for demographics, comorbidities and laboratory variables. Uromodulin levels were not associated with the hazard of first infectious hospitalization. When Cox regression was used to model multiple events per person, each doubling of uromodulin was associated with 23% lower risk of infectious hospitalization (HR 0.77, 95% CI 0.64, 0.94) in adjusted analyses.

Conclusion

Higher levels of uromodulin are associated with lower rates and hazard of total infectious hospitalizations. Uromodulin levels may provide information about global immune defense that may not be limited to urinary tract infections alone.

Funding

  • NIDDK Support