ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO171

Monocyte as a Marker of Renal Damage in Patients with Glomerular Hyperfiltration and Early CKD

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Oh, Sewon, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Junyong, Korea universtiy Anam hospital, Seoul, Korea (the Republic of)
  • Yang, Jihyun, Korea universtiy Anam hospital, Seoul, Korea (the Republic of)
  • Kim, Myung-Gyu, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea (the Republic of)
  • Jo, Sang-Kyung, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea (the Republic of)
Background

Experimental studies have shown that monocyte/macrophages play an important role in progression of chronic kidney disease (CKD). Recent epidemiologic study also suggests a significant association between higher monocyte count and risk of incident CKD in humans. Glomerular hyperfiltration (GH) is known as an early marker of progressive CKD in diverse clinical conditions. However, not all patients with GH progressed to CKD and monocyte may be associated with renal injuries caused by GH. The purpose of this study is to examine whether higher monocyte count is associated with GH and progressive kidney disease.

Methods

A longitudinal observational cohort study was performed using data from regular health checkup examinations in tertiary hospital during 2004-2017. We analyzed 56,258 adults at initial examination and selected 16,695 adults who had initial estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73m2 with at least two tests of eGFR in follow-up analysis. Monocyte count was categorized into sex-specific quartiles. GH was defined as the upper 2.5 percentile of eGFR in the total population.

Results

The monocyte count showed a U-shaped association with eGFR. The monocyte count was significantly higher in participants with eGFR ≥ 120, 60-74, 45-59, 30-44, and <30 ml/min/1.73m2 compared with those with eGFR 90-104 ml/min/1.73m2 at initial examination (N=56,258, P≤0.025). The highest quartile of monocyte count was independently associated with GH in multivariate analysis compared with the lowest quartile (OR, 1.278; 95% CI, 1.070-1.525). In participants without GH, the highest quartile of monocyte count was associated with the higher risk of ≥ 25% eGFR decline (RR, 1.859; 95% CI, 1.254-2.755) and the development of proteinuria (RR, 1.377; 95% CI, 1.135-1.671) compared with lowest quartile. In participants with GH, the highest quartile was also associated with increased risk for the development of proteinuria (RR, 5.833; 95% CI, 1.196-28.453), but was not associated with ≥ 25% eGFR decline.

Conclusion

Higher monocyte count is associated with progressive CKD. In addition, monocyte count could be a marker to identify patients at risk for progression of kidney disease in GH.