Kidney Week

Abstract: FR-PO439

Urinary Epidermal Growth Factor Predicts Rapid GFR Decline in the General Non-Diabetic Population

Session Information

• CKD: Risk Factors for Incidence and Progression - II
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 301 CKD: Risk Factors for Incidence and Progression

Authors

• Norvik, Jon V., University Hospital of North Norway, Tromsø, Norway

Jon V. Norvik,

• Ju, Wenjun, University of Michigan, Ann Arbor, Michigan, United States

Wenjun Ju,

• Nair, Viji, University of Michigan, Ann Arbor, Michigan, United States

Viji Nair,

• Stefansson, Vidar T. N., UiT The Arctic University of Norway, Tromso, Norway

Vidar T. N. Stefansson,

• Schei, Jørgen, University Hospital of North Norway, Tromsø, Norway

Jørgen Schei,

• Jenssen, Trond G., Oslo University Hospital, Oslo, Norway

Trond G. Jenssen,

• Solbu, Marit D., University Hospital of North Norway, Tromsø, Norway

Marit D. Solbu,

• Kretzler, Matthias, U.Michigan, Ann Arbor, Michigan, United States

Matthias Kretzler,

• Eriksen, Bjorn Odvar, University of Tromsø, Tromsø, TROMS, Norway

Bjorn Odvar Eriksen,

• Melsom, Toralf, University Hospital of North Norway, Tromsø, Norway

Toralf Melsom,

Background

Biomarkers are needed to distinguish people at high risk to develop chronic kidney disease (CKD) for early and targeted clinical care. Lower levels of urinary epidermal growth factor (uEGF) have been associated with increased tubular atrophy, interstitial fibrosis and rapid progression in CKD of various etiologies. We investigated whether lower uEGF predicted risk for rapid glomerular filtration rate (GFR) decline in the general non-diabetic population.

Methods

In the Renal Iohexol Clearance Survey of Tromsø 6 (RENIS-T6), we measured GFR by iohexol-clearance in 1,594 middle-aged persons without diabetes or chronic kidney disease. Of these, 1,299 (81%) had a follow-up GFR measurement after a median of 5.6 years in the RENIS-Follow Up and a random sample of 87 persons had a third GFR measurement. uEGF levels at baseline were measured using an ELISA assay. We used a linear mixed model with random intercept and slope to assess the relationship between uEGF and change in GFR and a multiple logistic regression model to examine the association between uEGF and rapid GFR decline (defined as annual GFR decline > 3 mL/min/1.73m²).

Results

The mean (SD) annual GFR decline rate was -0.86 (2.13) mL/min/1.73m². Lower baseline uEGF was independently associated with a steeper GFR decline rate (-0.16 (95% confidence interval (CI) -0.26 to -0.05) mL/min/1.73m² per 1 SD decrease in log-transformed uEGF after adjusting for CKD risk factors such as urinary albumin-to-creatinine ratio (ACR)). The annual GFR decline rate for participants with uEGF levels below the median was -1.00 (95% CI -1.14 to -0.86) mL/min/1.73m² compared to -0.71 (95% CI -0.86 to -0.56) mL/min/1.73m² for those above the median level (P=0.006), adjusted for sex, age and ACR. The multivariable adjusted odds ratio for rapid decline was 1.91 (95% CI 1.27 to 2.88) for those with uEGF below the median level.

Conclusion

Lower uEGF levels predicted rapid GFR decline in the general non-diabetic population.

Funding

• Government Support - Non-U.S.