Abstract: TH-PO1078
Clinical Utility of Tenascin-C Levels in Patients with CKD
Session Information
- CKD Progression and Complications: Diagnosis, Prognosis, Risk Factors
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Lim, Zhen Yu Z., National University Hospital, Singapore, Singapore, Singapore
- Mohamad, Hazirah, National University Hospital, Singapore, Singapore, Singapore
- Chan, Gek Cher, National University Hospital, Singapore, Singapore, Singapore
- Teo, Boon Wee, National University Hospital, Singapore, Singapore, Singapore
Background
Tenascin-C (TNC), an extracellular matrix protein, is a novel biomarker associated with kidney fibrosis. Within the kidney, it activates fibroblasts and induces epithelial-mesenchymal transition. Increased levels of TNC have been seen in kidney biopsies of patients with chronic kidney disease (CKD). Current literature lacks studies evaluating TNC and associations with clinical parameters and clinical outcomes.
Methods
We retrieved prospectively collected 24-hour urinary and plasma samples from 126 CKD patients and 99 healthy participants. TNC levels were assayed using IBL Tenascin-C Large (FNIII-B) assay kit. TNC concentration was assessed for associations with serum creatinine, cystatin-C, eGFR albuminuria, and rate of eGFR decline. Other factors evaluated include age, gender and body mass index. Differences in TNC concentration between groups were compared using analysis of variance, chi-squared tests. Univariate analysis was performed to assess correlation between TNC and variables of interest. Multiple regression analysis was performed to identify predictors of eGFR decline/year. Significance was taken at P < 0.05.
Results
CKD patients versus healthy participants: age (59 vs. 42), gender (44% female vs. 51%), non-smokers (78% vs. 81%), BMI (27.7 vs. 24.8), eGFR (45 vs. 100mL/min/1.73m2), serum creatinine (171 vs. 69 µmol/L). 24-hour urinary concentration of TNC is elevated in CKD patients (1.45 vs. 0.32ng/ml, p<0.001). It is associated with serum creatinine levels (p<0.001), serum cystatin-C levels (p<0.001), eGFR (p<0.001) and albuminuria (<0.001). Urinary TNC concentration is highest in patients with diabetes mellitus (DM, n=52), followed by non-DM (n=43) and healthy controls (n=92). (1.86, 0.95, 0.32ng/ml, p<0.001). In CKD patients, urinary TNC concentration is associated with rate of eGFR decline/year (p<0.001). Plasma TNC concentration was not associated with eGFR, albuminuria and GFR decline.
Conclusion
24-hour urinary tenascin C level offers novel clinical utility in management of patients with CKD. Early detection of high risk CKD patients will allow for earlier intervention and may serve to delay ESKD onset.
Funding
- Other NIH Support