Kidney Week

Abstract: SA-PO1197

Association of Urinary Mitochondrial DNA with Kidney Disease Severity: MAP-CKD Study

Session Information

• CKD: Biomarkers and Emerging Tools for Diagnosis and Monitoring
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Ahmadi, Armin, University of California San Diego, La Jolla, California, United States

Armin Ahmadi, PhD

• Li, Xinrui, University of California San Diego, La Jolla, California, United States

Xinrui Li

• Yang, Jason W., University of California San Diego, La Jolla, California, United States

Jason W. Yang, MS

• Ghanim, Basma, University of California San Diego, La Jolla, California, United States

Basma Ghanim

• Houben, Alfons Jhm, Maastricht Universitair Medisch Centrum+, Maastricht, LI, Netherlands

Alfons Jhm Houben, PhD

• Hepokoski, Mark, University of California San Diego, La Jolla, California, United States

Mark Hepokoski, MD

• Malhotra, Rakesh, University of California San Diego, La Jolla, California, United States

Rakesh Malhotra, MD, MPH, FASN

• Ix, Joachim H., University of California San Diego, La Jolla, California, United States

Joachim H. Ix, MD, FASN

Background

Little is known about urinary mitochondrial DNA (mtDNA). We hypothesize higher levels may indicate kidney tubule damage. Here, we evaluated the association between urinary mtDNA levels and CKD severity.

Methods

We recruited 98 adults with CKD (eGFR < 60 mL/min/1.73 m² using the CKD-EPI equation) as a part of the microvascular assessment in kidney disease (MAP-CKD) study. Absolute urinary mtDNA levels were quantified in a subset of participants (n=69) using droplet digital PCR targeting the NADH dehydrogenase 1 (ND1) gene. Associations between urinary mtDNA and CKD stage were assessed using the Kruskal-Wallis test with the Dunn multiple comparison test. Spearman rank correlation coefficient was used to assess relationship between urinary mtDNA with eGFR.

Results

Among the 69 participants with eGFR < 60 mL/min/1.73 m², the mean (SD) age was 66 (13) years with a mean eGFR of 36 (13) (mL/min/1.73 m²). Fifty percent were female, 40% had diabetes, and 75% had hypertension. The median urinary mtDNA level was 8 ND1 copies/ul (IQR of 3.3 - 26.8). Urinary mtDNA levels increased progressively with CKD stage (Figure 1A). Urinary mtDNA levels were inversely correlated with eGFR (r=-0.42, P<0.001) (Figure 1B).

Conclusion

Elevated urinary mtDNA levels are associated with lower kidney function supporting its utility as a noninvasive biomarker of tubular injury and CKD severity.

Figure 1. (A) Urinary mtDNA levels across CKD stages and (B) the correlation of urinary mtDNA with eGFR (n=69).

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025rg0ka827