Abstract: TH-OR62
Kidney Function Biomarkers Among American Indians (AI) and Hispanic Americans (HA)
Session Information
- Preventing Progression and Reassessing Race in GFR Estimation
November 04, 2021 | Location: Simulive, Virtual Only
Abstract Time: 04:30 PM - 06:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Moya Balasch, Monica, University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
- Argyropoulos, Christos, University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
- Roumelioti, Maria-Eleni, University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
Background
The NKF-ASN Task Force recommends that kidney function be estimated by an approach that is accurate introducing bias through racial adjustments. Use of multiple biomarkers may offer such an approach which we explored in a prospective community cohort of HA and AI in rural New Mexico.
Methods
Markers of kidney function, IDMS-Creatinine (SCr), chemiluminescence Beta-2 Microglobulin (B2M), Nephelometry-calibrated ELISA Cystatin C( CysC), inflammation, glucose tolerance, demographics, BUN/UACR from the baseline visit of the COMPASS cohort (PMID: 29486722), were analyzed by kernel-based machine learning methods.
Results
Cohort consisted of 172 individuals, 61% female, 30.2% AI, 54.7% HA, age 51.1 ± 18, SBP/BP 128 ±14.4/77.4 ± 11.5 mmHg, Height 1.7 ±0.1m, Weight 83 ± 20 kg, BUN 14±5 mg/dl, SCr 0.9 ±0.3 mg/dl, B2M 1.8 ± 0.5 mg/L, CysC 0.7 ± 0.2 mg/dl, UACR 43.8 ± 231 mg/g, hs-CRP 4.8 ± 6.7 mg/L, HbA1c ± 1.7 %. B2M was not associated with race/ethnicity/anthropometrics. CysC had the most non-kidney determinants [Table]. 75% of all log10 transformed values culustered together [Figure, yellow] . Ethnicity (p=0.02), HbA1c (p=0.03), hs-CRP (p=0.04) predicted discordance among the biomarkers (mauve).
Conclusion
Ethnicity, inflammation and diabetes increase discordance among kidney biomarkers. B2M was affected the least and should be strongly considered as a measure fulfilling the criteria for the NKF-ASN because its eGFR equation does not need adjustment for race or sex(PMID: 26362696)
Predictors of kidney biomarkers
| Age | Sex | Ethnicity (HI) | Race (AI) | Albumin (serum) | UACR | BUN | SBP | Weight x Height x Gender response surface | |
| SCr | 0.99 | 0.44 | 0.33 | 0.03 | 0.13 | 0.90 | <10^-10 | 0.001 | 0.02 |
| B2M | 0.01 | 0.88 | 0.78 | 0.21 | 0.03 | 0.57 | 10^-5 | 0.01 | 0.66 |
| CysC | 0.02 | 0.85 | 0.04 | 0.74 | 0.80 | 0.02 | 0.001 | 0.04 | 10^-4 |
p-values (ANOVA) from null-space kernel regression. DBP & hs-CRP were not predictive of any biomarker
Funding
- Other NIH Support – Dialysis Clinic Incorparated