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Abstract: PO0554

Sensitivity of Urinary N-Terminal Osteopontin-to-Creatinine Ratio in Predicting Renal Function Loss

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Sun, Ling, Xuzhou City Centre Hospital, Xuzhou, Jiangsu, China
  • Sinha, Satyesh K., UCLA, University of California Los Angeles, Los Angeles, California, United States
  • Lusis, Aldons J., UCLA, University of California Los Angeles, Los Angeles, California, United States
  • Nicholas, Susanne B., UCLA, University of California Los Angeles, Los Angeles, California, United States

Group or Team Name

  • Metabolic Syndrome In Men (METSIM)
Background

Osteopontin (OPN) is a multifunctional protein that gets cleaved to create N- terminal OPN (ntOPN). ntOPN has been reported in urine in kidney diseases but little is known about the sensitivity of ntOPN to creatinine ratio (ntOCR) as a urinary biomarker compared to the urinary albumin-to-creatinine ratio (UACR). This study is aimed to explore the prognostic value of ntOCR regarding renal function loss in a subset of the metabolic syndrome in men (METSIM) study with a high incidence of diabetes mellitus.

Methods

The METSIM study recruited 10,197 Finnish men between 2005 and 2010 and reexamined participants at two 5-year follow-ups. We performed a prospective observational study of a METSIM cohort of 137 participants, 45-72 years old at entry, with available urine at baseline and the first follow-up period, after 3.8±1.4 years. Serum and urinary levels of the ntOPN were quantified by ELISA. Using estimated glomerular filtration rate (eGFR), UACR and urine albumin excretion (UAE) of progressors and non-progressors, data were analyzed by paired t-test and Wilcoxon matched-pairs signed-rank test. The area under the receiver-operating characteristics (ROC) curve (AUC) was used to assess the sensitivity/specificity of variables in predicting the progression of CKD. Pearson correlation coefficient was performed to detect the relationships between the values of variables.

Results

Compared to the CKD non-progressors, the progressors had significantly higher eGFR at baseline (96.95 vs. 87.75 mL/min/1.73 m2, p<0.00) and lower eGFR at follow-up (86.11 vs. 91.40 mL/min/1.73 m2, p=0.01). The baseline urine levels of ntOCR were higher in progressors than non-progressors (6.83 vs 3.68 pmol/mg, p=0.05). There were no differences in the UAE, UACR, or serum ntOPN between the two groups. However, baseline urinary ntOCR predicted renal function loss with an AUC of 0.60 (p=0.05), and the change between baseline and follow-up had a higher AUC value of 0.63 (p=0.01).

Conclusion

Our study suggests that urinary ntOCR might be a promising predictive biomarker for renal function loss in a population with high rates of metabolic syndrome and diabetes. Measurements at the second METSIM follow-up may confirm this observation. Further studies are needed in females, larger size populations, and long-term follow up.

Funding

  • Other NIH Support