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Abstract: TH-PO861

Association Between Urine Uromodulin and Interstitial Fibrosis

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Bullen, Alexander L., University of California San Diego, La Jolla, California, United States
  • Ix, Joachim H., University of California San Diego, La Jolla, California, United States
  • Rifkin, Dena E., University of California San Diego, La Jolla, California, United States
  • Garimella, Pranav S., University of California San Diego, La Jolla, California, United States
Background


Tubular atrophy and interstitial fibrosis are common findings in virtually all forms of chronic kidney disease. The severity of tubular atrophy and fibrosis on kidney biopsy is strongly predictive of progression to kidney failure; however, this damage is poorly correlated with either eGFR or albuminuria. The only form to identify interstitial fibrosis is with a kidney biopsy. Identifying interstitial fibrosis in a noninvasive manner would be of extreme value. Urine uromodulin (uUMOD) is a marker of the renal reserve, and low concentrations of uUMOD have been associated with chronic kidney disease progression. The association between uUMOD and tubulointerstitial fibrosis is uncertain.

Methods

Among 52 individuals who underwent kidney biopsy for clinical reasons, we measured uUMOD. The percentage of fibrosis was determined by morphometry technique. Due to skewed distribution, we log-transformed uUMOD. We used linear regression to evaluate the association between uUMOD and fibrosis, adjusting for age, sex, urine creatinine, obesity, diabetes, hypertension, baseline eGFR, and albuminuria.

Results

Among the 52 study participants, the mean age was 42 years, 48% were women, 23% had diabetes, and the mean eGFR was 64 ml/min/1.73m2. The mean uUMOD was 5.1 mcg/mL. Participants in the lowest tertile of uUMOD had more hypertension and diabetes mellitus and lower eGFR. Each doubling of urine uromodulin was associated with 1.88% decrease in fibrosis greater or equal to 25% (moderate or severe) after adjusting for all the covariates, including baseline eGFR and albuminuria.

Conclusion

Assessment of tubule function by measurement of uUMOD provides information on interstitial fibrosis, independent of eGFR and albuminuria.

Funding

  • Veterans Affairs Support