Abstract: SA-PO1113
Urinary Biomarkers and Joint Cognition-Gait Trajectories: Findings from the Health, Aging, and Body Composition (ABC) Study
Session Information
- Geriatric Nephrology
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Geriatric Nephrology
- 1300 Geriatric Nephrology
Authors
- Shrestha, Aman, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States
- Shardell, Michelle, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States
- Chen, Chixiang, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States
- Seliger, Stephen L., University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States
- Ginsberg, Charles, University of California San Diego, La Jolla, California, United States
- Miller, Lindsay M., University of California San Diego, La Jolla, California, United States
- Cawthon, Peggy M., California Pacific Medical Center, San Francisco, California, United States
Background
Emerging urinary biomarkers can unlock new links between kidney tubular injury and cognitive-physical function.
Methods
Using the Health ABC Study, we examined baseline urinary biomarkers—uromodulin, alpha-1 microglobulin (α1M), amino-terminal propeptide of type-III procollagen (PIIINP), neutrophil gelatinase-associated lipocalin (NGAL), interlukin-18 (IL-18), and kidney injury molecule-1 (KIM-1)—and joint cognition-gait trajectories among baseline high-function older adults. IL-18 and KIM-1 were measured in n=1902 participants; uromodulin, α1M, PIIINP and NGAL were measured in a random subcohort (n=502). Group-based trajectory analysis of 20m usual gait speed and modified Mini-Mental State up to year 10 revealed three groups: high cognitive-physical function (Group 1), stable cognition/declining gait (Group 2), and rapid joint decline (Group 3).
Results
After adjusting for covariates in separate models (Model-1A), higher α1M (p=0.043) and KIM-1 (p=0.005) concentrations were related to worse trajectories (Table). Further adjustment for estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR) and c-reactive protein (CRP) (Model-1B) attenuated estimates; KIM-1 was not quite significant (p=0.059). In a fully adjusted model of all urinary markers (Model-2), only KIM-1 was significant (p=0.012), but the set of urinary biomarkers was jointly significant (p=0.022).
Conclusion
KIM-1 was robustly related to cognitive-gait decline, and may link kidney tubular injury with aging-related functional outcomes.
Table. Multinomial Regression
| Biomarker (per-doubling at Year 1) | Group (vs. 1) | Model 1A | Model 1B | Model 2 | ||||||||||||
| N | OR | 95%CI | p-value | Joint p-value | N | OR | 95%CI | p-value | Joint p-value | N | OR | 95%CI | p-value | Joint p-value | ||
| Uromodulin (ng/mL) | 2 | 294 | 0.86 | 0.62–1.20 | 0.38 | 0.12 | 274 | 0.81 | 0.55–1.19 | 0.29 | 0.22 | 195 | 0.66 | 0.37–1.18 | 0.16 | 0.077 |
| 3 | 1.16 | 0.78–1.73 | 0.47 | 1.09 | 0.69–1.17 | 0.704 | 1.23 | 0.61–2.48 | 0.57 | |||||||
| α1M (mg/dL) | 2 | 205 | 1.46 | 0.85–2.52 | 0.17 | 0.043 | 198 | 1.40 | 0.77–2.57 | 0.27 | 0.39 | 0.55 | 0.24–1.28 | 0.16 | 0.38 | |
| 3 | 2.14 | 1.17–3.93 | 0.014 | 1.61 | 0.81–3.20 | 0.18 | 0.63 | 0.24–1.66 | 0.35 | |||||||
| PIIINP (μg/L) | 2 | 287 | 1.26 | 0.98–1.63 | 0.071 | 0.090 | 269 | 1.26 | 0.96–1.64 | 0.092 | 0.24 | 1.73 | 0.80–3.78 | 0.17 | 0.17 | |
| 3 | 1.42 | 1.00–2.01 | 0.051 | 1.18 | 0.83–1.68 | 0.36 | 2.50 | 0.95–6.58 | 0.064 | |||||||
| NGAL (ng/mL) | 2 | 294 | 0.94 | 0.83–1.06 | 0.31 | 0.34 | 274 | 0.93 | 0.81–1.05 | 0.25 | 0.39 | 0.80 | 0.66–0.98 | 0.027 | 0.060 | |
| 3 | 1.03 | 0.89–1.19 | 0.69 | 1.01 | 0.85–1.18 | 0.95 | 0.96 | 0.74–1.23 | 0.73 | |||||||
| IL-18 (pg/mL) | 2 | 1436 | 1.05 | 0.96–1.15 | 0.29 | 0.14 | 1360 | 1.04 | 0.94–1.14 | 0.47 | 0.52 | 1.30 | 0.81–2.09 | 0.28 | 0.11 | |
| 3 | 1.11 | 1.00–1.24 | 0.048 | 1.07 | 0.95–1.20 | 0.25 | 0.80 | 0.46–1.40 | 0.44 | |||||||
| KIM-1 (pg/mL) | 2 | 1529 | 1.13 | 1.03–1.25 | 0.015 | 0.005 | 1434 | 1.12 | 1.01–1.25 | 0.044 | 0.059 | 2.00 | 1.27–3.15 | 0.003 | 0.012 | |
| 3 | 1.21 | 1.08–1.36 | 0.002 | 1.16 | 1.02–1.32 | 0.025 | 1.81 | 1.01–3.25 | 0.046 | |||||||
Model-1A = Adjusted for sociodemographics. Model-1B = Additionally adjusted for CKD-EPI eGFR, log-2 UACR and log-2 serum CRP. Model-2 = Additionally adjusted for all other biomarkers. P Model-2 versus model without urinary markers, p=0.022.
Funding
- Other NIH Support