Introduction:
Transforming growth factor-beta (TGF-β) has both fibrotic and protective roles; as a mediator of fibrosis, it can serve as a novel biomarker for early diagnosis and prediction of chronic kidney disease (CKD) progression. Chronic kidney disease (CKD) can occur silently and progress to end stage kidney disease (ESKD) in resource constrained settings.
Methods:
This was a prospective longitudinal study among black patients with CKD who attended the kidney outpatient clinic between September 2019 and March 2022 at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in South Africa. Patients provided urine and blood samples for laboratory investigations at study entry (0) and at 24 months follow up. Serum and urine (TGF)-β1, TGF-β2 and TGF-β3 levels were measured only at baseline using the Human TGF-β duoset ELISA. Multivariable logistic regression analysis was utilized to determine if TGF-β isoforms predicted CKD progression.
Results:
A total of 312 patients who were enrolled in the study, 297 (95.2%) patients completed the study. After 2 years of follow up, the prevalence of CKD progression was 47.8% by a sustained decline in eGFR of >4 ml/min/1.73 m2/year or more and 51.9% by a change in uPCR > 30 %. Of the patients with CKD progression, 54.9% were men and the median age at baseline was 59 (46 - 67) years in CKD progressors and 56 (45 - 66) years in those who had no CKD progression. Significant variables were lower baseline median eGFR and increased median urine protein creatinine ratio (uPCR), both of which were significantly different in CKD progressors than in non-progressors. Comparing patients with, and those without CKD progression, the median serum TGF-β1 was 21210 (15915 – 25745) ng/L vs 24200 (17570 – 29560) ng/L, the median urine TGF-β3 was 17.5 (5.4 – 76.2) ng/L vs 2.8 (1.8 – 15.3) ng/L respectively. There was no significant association of baseline serum and urine TGF-β isoforms with CKD progression after multivariable logistic regression analysis.
Conclusions:
Patients with CKD progression had lower concentrations of serum TGF-β1 and increased urinary TGF-β3 concentrations at baseline. However, baseline TGF-β isoforms did not predict CKD progression. The search for more sensitive biomarkers for predicting CKD progression is necessary.
The abstract has been submitted to the South Africa Renal Society Scientific Conference scheduled for October 2024. I also declare that re-submitting the abstract is permitted by the organizers of SARS 2024.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.