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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

Category: CKD (Non-Dialysis)

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

Authors

  • Weinreich, Thomas, Nephrological Center Villingen-Schwenningen, Villingen-Schwenningen, Germany
  • Seibert, Eric, Nephrological Center Villingen-Schwenningen, Villingen-Schwenningen, Germany
  • Brohammer, Elias, Hahn-Schickard-Gesellschaft fur angewandte Forschung eV, Villingen-Schwenningen, Baden-Württemberg, Germany
  • Rüb, Marcus, Hahn-Schickard-Gesellschaft fur angewandte Forschung eV, Villingen-Schwenningen, Baden-Württemberg, Germany
  • Gehlen, Frank, Nephrological Center Villingen-Schwenningen, Villingen-Schwenningen, Germany
  • Sikora, Axel, Hahn-Schickard-Gesellschaft fur angewandte Forschung eV, Villingen-Schwenningen, Baden-Württemberg, Germany
  • Hohenstein, Bernd, Nephrological Center Villingen-Schwenningen, Villingen-Schwenningen, Germany
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 1st 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 31st 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.