Kidney Week

Abstract: FR-PO914

Evaluation of the Biomarker Dickkopf 3 in More Than 1100 CKD Patients of a German Single Center Cohort Using Algorithm-Based Data Analysis

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - II
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

• Weinreich, Thomas, Nephrological Center Villingen-Schwenningen, Villingen-Schwenningen, Germany

Thomas Weinreich,

• Seibert, Eric, Nephrological Center Villingen-Schwenningen, Villingen-Schwenningen, Germany

Eric Seibert,

• Brohammer, Elias, Hahn-Schickard-Gesellschaft fur angewandte Forschung eV, Villingen-Schwenningen, Baden-Württemberg, Germany

Elias Brohammer,

• Rüb, Marcus, Hahn-Schickard-Gesellschaft fur angewandte Forschung eV, Villingen-Schwenningen, Baden-Württemberg, Germany

Marcus Rüb,

• Gehlen, Frank, Nephrological Center Villingen-Schwenningen, Villingen-Schwenningen, Germany

Frank Gehlen,

• Sikora, Axel, Hahn-Schickard-Gesellschaft fur angewandte Forschung eV, Villingen-Schwenningen, Baden-Württemberg, Germany

Axel Sikora,

• Hohenstein, Bernd, Nephrological Center Villingen-Schwenningen, Villingen-Schwenningen, Germany

Bernd Hohenstein,

Background

Dickkopf 3 (Dkk3) has been identified as a urinary biomarker and values above 4000 pg/mg creatinine (Cr) were assumed to be linked with the risk of short-term decline of kidney function (J Am Soc Nephrol 29: 2722–2733). However, as of today, there is little experience of DKK3 as a risk marker in everyday clinical practice. We used algorithm-based data analysis to evaluate the potential dependence of DKK3 in a cohort from a large single center in Germany.

Methods

DKK3 was measured in all CKD patients (pts) in an outpatient clinic from October 1^st 2018 till Dec. 31 2019, together with calculated GFR (eGFR) and urinary albumin/creatinine ratio (UACR). Pts with a kidney transplant were excluded. Until the end of follow-up Dec 31^st 2021 repeated measurements (mm) were performed for all parameters.
Data analysis was performed using MD-Explorer (BioArtProducts, Rostock, Germany) and Python with multiple libraries. Linear regression models were applied in Pts for DKK3, eGFR and UACR. Comparison of the models was performed with a two-sided Kolmogorov-Smirnov test.

Results

1206 DKK3 mm were performed in 1103 pts (621 male, age 70yrs, eGFR 29,41 ml/min/1.73qm, UACR 800mg/g). 134 pts died during follow-up. DKK3 mean was 2905 pg/mg Cr (max. 20000, 75% percentile 3800). 121 pts had a DKK3 >4000. At the end of follow-up 7% of pts with DKK3<4000 (initial eGFR 17.6) versus 39.6% of pts with DDK3>4000 (initial eGFR 15.7) underwent dialysis. Compared to eGFR and UACR at baseline, DKK3>4000 performed best to predict eGFR for the next 12 months.

Conclusion

DKK3>4000 reflected a higher risk of progression towards ESRD despite similar eGFR levels. IN this cohort of CKD patient, DKK3 >4000 at baseline predicted the eGfR slope better than eGFR or UACR.