Kidney Week

Abstract: FR-PO170

Association of Serum Uromodulin with ESRD and Kidney Function Decline in the Elderly – The Cardiovascular Health Study

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Steubl, Dominik, Tufts Medical Center, Tufts University, Boston, Massachusetts, United States

Dominik Steubl,

• Buzkova, Petra, UW, Seattle, Washington, United States

Petra Buzkova,

• Garimella, Pranav S., UCSD, San Diego, California, United States

Pranav S. Garimella,

• Ix, Joachim H., UCSD, San Diego, California, United States

Joachim H. Ix,

• Devarajan, Prasad, Cincinnati Children's Hospital, Cincinnati, Ohio, United States

Prasad Devarajan,

• Bennett, Michael R., Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Michael R. Bennett,

• Chaves, Paulo H. M., Florida International University, Miami, Florida, United States

Paulo H. M. Chaves,

• Shlipak, Michael, San Francisco VA Medical Center, San Francisco, California, United States

Michael Shlipak,

• Sarnak, Mark J., Tufts Medical Center, Boston, Massachusetts, United States

Mark J. Sarnak,

Background

Uromodulin is released by tubular epithelial cells into the serum (sUMOD) and low levels are associated with tubular atrophy and interstitial fibrosis (IF/TA). However, little is known about the association of sUMOD with long-term kidney outcomes in the elderly, a population with a high prevalence of IF/TA.

Methods

We assessed the association of sUMOD with end-stage-renal-disease (ESRD) in a random subcohort (n=933) plus all additional cases of ESRD in the Cardiovascular Health Study using a modified Cox regression analysis. We also evaluated the association of sUMOD with kidney function decline (≥30% decline of estimated glomerular filtration rate (eGFR) at 10 years of follow up) using logistic regression. Sampling for the latter was from the random subcohort as well as all additional cases. Models were adjusted for demographics, eGFR, albuminuria and other risk factors.

Results

Mean age of the random subcohort was 78 years, 40% were male, and 15% were non-white. Mean±SD sUMOD level was 127±64 ng/ml and eGFR was 63±19 ml/min/1.73 m². 53 participants experienced ESRD during a median follow-up 9.9 years. Higher sUMOD was associated with lower hazard for ESRD in univariate analysis (Figure). In multivariable analysis each 1 SD higher sUMOD was associated with a 63% lower risk of ESRD (HR 0.37 (95%-CI 0.14-0.95)). 179 participants experienced kidney function decline. In demographic adjusted analyses, higher sUMOD was associated with lower odds of kidney function decline (OR 0.75 (0.60-0.95)); after multivariable adjustment, the association was attenuated and no longer significant (OR 0.88 (0.68-1.14)).

Conclusion

Low levels of sUMOD may identify persons at increased risk for ESRD.

Funding

• NIDDK Support