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Kidney Week

Abstract: TH-PO408

Association of Serum Uromodulin with Mortality, Cardiovascular Disease, and Kidney Function Decline in CKD Patients: The GCKD Study

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Steubl, Dominik, Klinikum rechts der Isar , Munich, Germany
  • Schneider, Markus P., Klinikum Nuremberg, Nuremberg, Germany
  • Meiselbach, Heike, Nephrology and Hypertension, Erlangen, Germany
  • Nadal, Jennifer, IMBIE, Bonn, Germany
  • Saritas, Turgay, RWTH Aachen, Aachen, Germany
  • Krane, Vera, University of Wuerzburg, Wuerzburg, Germany
  • Sommerer, Claudia, University Hospital of Heidelberg, Heidelberg, Germany
  • Baid-Agrawal, Seema, Sahlgrenska University Hospital, University of Gothenburg, Gothenburrg, Sweden
  • Kottgen, Anna, Medical Center - University of Freiburg, Freiburg, Germany
  • Eckardt, Kai-Uwe, Charité – Universitätsmedizin Berlin, Berlin, Germany
  • Scherberich, Juergen Eberhard, University Munich Klinikum Muenchen Harlaching, Muenchen Gruenwald, Germany
Background

Uromodulin is exclusively produced by tubular cells and released into both urine and serum. Lower sUMOD has been associated with end-stage renal disease (ESRD) in Chinese chronic kidney disease (CKD) patients and with higher risk for mortality in patients undergoing coronary angiography. The association of sUMOD with mortality, cardiovascular (CV) events and ESRD in Caucasian CKD patients is unknown.

Methods

We measured sUMOD in 5143 participants enrolled in the German Chronic Kidney Disease (GCKD) study. The associations of baseline sUMOD with all-cause mortality, major adverse CV events (MACE; a composite of fatal CV event, non-fatal myocardial infarction or stroke, or incident peripheral vascular disease) and ESRD (dialysis or transplantation) were evaluated using multivariable Cox regression analysis, adjusting for demographics, estimated glomerular filtration rate (eGFR), albuminuria, CV risk factors and medication.

Results

The mean age was 60±12 years, 60% were male. sUMOD level was 98±60 ng/ml, eGFR was 47±17 ml/min/1.73 m2and 78% had eGFR<60 ml/min/1.73 m2. Patients in the lower sUMOD quartiles had lower eGFR and higher albuminuria. Prevalent diabetes, hypertension, coronary artery disease and stroke at baseline were more frequent in lower sUMOD quartiles. During a follow-up of 4 years, 319 patients died, 398 developed MACE and 216 ESRD (Table 1). In multivariable analysis, higher sUMOD was significantly associated with lower hazard for mortality (HR 0.572, 95%-CI [0.377-0.869] for the highest versus lowest quartile), MACE (HR 0.632 [0.445-0.898]) and ESRD (HR 0.238 [0.103-0.547], Table 1).

Conclusion

Higher sUMOD is independently associated with lower risk for mortality, CV events and ESRD in Caucasian CKD patients. A better understanding of the underlying mechanisms may lead to therapies offering both renal and CV protection in CKD patients.