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Kidney Week

Abstract: TH-PO547

Diagnostic Performance of a Unique Fragment of Human Fetuin-A for Patients Undergoing Native Kidney Biopsy

Session Information

  • Pathology and Lab Medicine
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pathology and Lab Medicine

  • 1700 Pathology and Lab Medicine

Authors

  • Tsai, Ming-Tsun, Taipei Veterans General Hospital, Taipei, Taiwan, Taiwan
  • Tseng, Wei-Cheng, Taipei Veterans General Hospital, Taipei, Taiwan, Taiwan
  • Tseng, Tzu-Ling, Bio Preventive Medicine Corp., Hsinchu, Taiwan
Background

Fetuin-A is a hepatokine secreted into the systemic circulation and regulates many biological processes. The relationship between fetuin-A and progression of chronic kidney disease (CKD) has been studied intensively, but its role in CKD and its complications remains to be clarified. Several types of post-translational modifications (PTMs) on fetuin-A are identified in patients with CKD, implying the possible effects of these modifications on renal structure and function.

Methods

A commercial immunoassay, DNlite-IVD103 supplied by Bio Preventive Medicine Corp., was used to measure urine levels of a unique PTM fetuin-A (uPTM-Fet-A) in a cohort of patients undergoing native kidney biopsies. Relationships between uPTM-Fet-A, clinical characteristics, and tubulointerstitial damage were analyzed with logistic regression. Furthermore, the accuracy of the uPTM-Fet-A in predicting the severity of tubulointerstitial fibrosis was evaluated by constructing receiver operating characteristic curves.

Results

To analyze the relationship between uPTM-Fet-A and clinical features, we divided the patients into two groups according to median levels of uPTM-Fet-A (65.6 ng/mg). The high-level group had a larger percentage of elderly male patients and patients with decreased renal function, higher levels of proteinuria, and severe renal fibrosis than the low-level group. After multivariate adjustment, renal impairment, hypoalbuminemia, and high-grade proteinuria were independently correlated with elevated levels of uPTM-Fet-A. Moremore, compared with the urine protein-to-creatinine ratio (uPCR), uPTM-Fet-A had a better performance in the diagnosis of different extents of renal fibrosis.

Conclusion

Our results suggested that uPTM-Fet-A may be a potential diagnostic biomarker for patients with CKD.

ROC curve analyses comparing the predictability in distinguishing the different grades of IFTA of the uPTM-Fet-A/Cre (ng/mg) with uPCR (mg/mg). The area under the curve (AUC) represents the probability to discriminate the presence of > 10% (A), > 25% (B), or > 50% (C) IFTA in the tissue samples.

Funding

  • Government Support – Non-U.S.