ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

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: TH-PO918

Determinants of Urinary C-Megalin Among a Large Diabetes Cohort: Albuminuria, Reduced Kidney Function, and Demographic Factors

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Kurita, Noriaki, Fukushima Medical University, Fukushima, Japan
  • Hayashino, Yasuaki, Tenri Hospital, Nara, Japan
Background

Urinary c-megalin is a multi-ligand receptor shed from proximal tubule cells. It is expected as a biomarker for early kidney injury associated with diabetic kidney disease (DKD) among diabetes. The aim of this study was to examine the determinants of urinary c-megalin values.

Methods

This single-center cross-sectional study included 1491 Japanese patients with diabetes (including 104 type 1 and 1387 type 2 diabetes). The outcome was urinary c-megalin measured by enzyme-linked immunosorbent assay and expressed as both urinary creatinine (Cr)-corrected value (unit: pM/gCr) and non-corrected value (unit: fM/L). The candidate predictors were: age, type 1 diabetes, hemoglobin, hemoglobin A1c, antihypertensives, estimated glomerular filtration rate (eGFR: ≥130, >90-<130 [ref.], >60-≤90, >30-≤60, ≤30 mL/min/1.73m2), and urine albumin Cr ratio (uACR: <10 [ref.], ≥10-<30, ≥30-<300 [i.e., microalbuminuria], ≥300 mg/gCr [i.e., macroalbuminuria]). The two-part model was fit to estimate the marginal effects of the predictors as urinary c-megalin values of both units have zero-inflated heavily skewed distributions.

Results

Cr-corrected c-megalin showed higher values associated with both microalbuminuria and macroalbuminuria (difference: 0.06 and 0.31 pM/gCr), whereas aging (≥65-<75 yr and ≥75 yr compared to <55 yr) was also associated with higher c-megalin values (Figure1). Uncorrected c-megalin showed higher values associated with macroalbuminuria (difference: 132 fM/L), eGFR >30-≤60, and ≤30 mL/min/1.73m2 (difference: 62 and 134 fM/L). For both units, higher c-megalin values were associated with male sex and lower hemoglobin values.

Conclusion

Uncorrected c-megalin was independently associated with reduced kidney function and macroalbuminuria, both of which were included in a current concept of DKD. However, for both units, careful interpretation would be required as anemia and sex affect both units and especially, aging affects Cr-corrected values.

Marginal effects of predictors on urinary c-megalin values expressed as Cr-corrected (left panel) and uncorrected values (right panel). Error bars indicate 95% confidence intervals.