Kidney Week

Abstract: FR-PO1165

Fetal Tenascin-C Variants as Potential Cardiovascular and Kidney Risk Markers in Patients with CKD: Results from the German CKD (GCKD) Study

Session Information

• CKD: Screening, Diagnosis, Serum and Urine Biomarkers, and Scoring Indices
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Busch, Martin, University Hospital Jena, Department of Internal Medicine III, Jena, Thuringia, Germany

Martin Busch, MD

• Paul, Katharina, University Hospital Jena, Department of Internal Medicine III, Jena, Thuringia, Germany

Katharina Paul, PhD

• Ruhe, Johannes Alexander, University Hospital Jena, Department of Internal Medicine III, Jena, Thuringia, Germany

Johannes Alexander Ruhe, MD

• Lehmann, Thomas, University Hospital Jena, Institute for Medical Statistics, Informatics and Data Sciences, Jena, Thuringia, Germany

Thomas Lehmann, PhD

• Bärthlein, Barbara, University Hospital Erlangen, Medical Clinic 4, Erlangen, Bavaria, Germany

Barbara Bärthlein

• Meiselbach, Heike, University Hospital Erlangen, Medical Clinic 4, Erlangen, Bavaria, Germany

Heike Meiselbach, DrPH

• Nadal, Jennifer, University Hospital Bonn, Institute for Medical Biometry, Informatics and Epidemiology, Bonn, Germany

Jennifer Nadal

• Wolf, Gunter B., University Hospital Jena, Department of Internal Medicine III, Jena, Thuringia, Germany

Gunter B. Wolf, MHBA, MD

• Franz, Marcus M, University Hospital Jena, Department of Internal Medicine I, Jena, Germany

Marcus M Franz, MD

• Köhler, Marie-Christin, University Hospital Jena, Department of Internal Medicine III, Jena, Thuringia, Germany

Marie-Christin Köhler

Group or Team Name

• GCKD Study Group.

Background

Fetal molecular variants of the cellular adhesion protein tenascin-C (Tn-C), which are undetectable in healthy adults, show re-expression in pathological conditions such as hypertensive organ damage, atherosclerosis, heart disease, or renal fibrosis. The aim of this study was to prospectively investigate the potential impact of two fetal Tn-C variants containing the extra domain B (B⁺ Tn-C) or C (C⁺ Tn-C) on cardiovascular and renal endpoints in patients with chronic kidney disease (CKD).

Methods

At inclusion in the GCKD study (Regional center of Jena), the serum concentrations of B⁺ Tn-C and C⁺ Tn-C were measured by ELISA in 278 CKD patients (63±8.8 y., 59% m.). Endpoints were recorded in an 8.5-year follow-up. Correlations were examined using the Spearman-Rho test, influences of Tn-C concentration on endpoints by Cox regression analyses.

Results

Weak correlations existed between Tn-C and C-reactive protein (median 2.3mg/L) for both B⁺ Tn-C (median(min-max): 470(0-2890)ng/mL, r=0.21 and C⁺ Tn-C (69.3(13.9-204.4)ng/mL, r=0.16, p<0.008, resp.). There were no correlations of Tn-C with eGFR (47(16-109)mL/min/1.73 m²) and uACR (36(1-7233)mg/gCrea). Within an 8.5-year follow-up, 51 patients died (all-cause mortality), 25 due to cardiovascular causes and 26 due to non-cardiovascular causes. A non-fatal major cardiac event (MACE; myocardial infarction, ischaemic stroke, peripheral arterial event) occurred in 40 cases, hospitalisation for heart failure in 30, and a renal event (dialysis or transplantation) in 33 cases. After adjustment for the baseline data age,gender,eGFR,uACR,BMI,previous cardiovascular disease, iabetes mellitus,LDL cholesterol,CRP and smoking status, Cox regression analysis (stepwise backward elimination) revealed C⁺ Tn-C (per increase of 10ng/mL) to be a significant independent predictor for the endpoints cardiovascular death HR 1.14 [95%CI 1.03-1.24], all-cause mortality HR 1.10 [95%CI 1.03-1.18], and renal event HR 1.13 [95%CI 1.03-1.23].

Conclusion

In this preliminary study, the fetal splice variant C⁺ Tn-C was identified as an independent cardiovascular and renal risk marker as well as a marker of all-cause mortality in patients with CKD.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025cmbfbvmw