ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: FR-PO0259

Association of Serum Lipocalin-2 (LCN2) with Thoracic Aortic Calcification in CKD Stage 5: A Cross-Sectional Study

Session Information

Category: Bone and Mineral Metabolism

  • 502 Bone and Mineral Metabolism: Clinical

Authors

  • Zhao, Yinan, Southeast University Zhongda Hospital, Nanjing, Jiangsu, China
  • Tang, Rining, Southeast University Zhongda Hospital, Nanjing, Jiangsu, China
Background

This study explores the association between serum neutrophil gelatinase-associated lipocalin (LCN2) and thoracic aortic calcification (TAC) in stage 5 chronic kidney disease (CKD) patients, while evaluating LCN2’s potential as a predictive biomarker for TAC in this population.

Methods

This cross-sectional study included 160 patients with CKD5 from three hospitals between May 2023 and 2025. TAC volume was quantified via dual-source spiral CT, and serum LCN2 levels were measured by ELISA. Bivariate/multivariate regression identified vascular calcification predictors. ROC curves evaluated LCN2's predictive value alone or combined with biomarkers, with model comparisons via DeLong’s test. A predictive model was validated by DCA for clinical benefit.

Results

Group Comparison Analysis
Patients with TAC had significantly higher serum LCN2, total cholesterol, albumin, alkaline phosphatase (ALP) , and parathyroid hormone (PTH) levels, and were older than those without calcification.
Correlation Analysis
Spearman’s analysis revealed a positive correlation between serum LCN2 levels and TAC volume in CKD5 patients (r = 0.569, P < 0.001).
Multivariate Logistic Regression and Model Performance
Multivariate logistic regression identified serum LCN2, ferritin, ALP, and PTH as independent predictors of vascular calcification in CKD (CKD-VC). Serum LCN2 alone yielded an AUC of 0.802 (95% CI: 0.705–0.898) for vascular calcification prediction, with a cutoff of 1007.405 ng/L (sensitivity 60.4%, specificity 88.9%). Model 1 (ferritin, ALP, PTH) had an AUC of 0.820 (95% CI: 0.719–0.897). Model 2, incorporating LCN2, improved AUC to 0.899 (95% CI: 0.812–0.955). DeLong’s test confirmed significant AUC improvement of Model 2 over Model 1 (Z = 1.986, P = 0.047), validating LCN2’s independent contribution to CKD-VC.
Clinical Utility of the Prediction Model
DCA demonstrated that the prediction model incorporating serum LCN2 provided a higher net clinical benefit compared to models excluding this biomarker.

Conclusion

Previous research shows that LCN2 promotes CKD-VC by aggravating vascular smooth muscle cell ferroptosis via NCOA4/FTH1-mediated ferritinophagy. Inhibiting LCN2 has therapeutic potential. This study suggests that LCN2 combined with clinical parameters improves calcification prediction accuracy, emphasizing its diagnostic and therapeutic potential.

Digital Object Identifier (DOI)