SuPAR AND IgM-uria IMPROVES PREDICTION OF PROGRESSION OF EARLY CKD1-3. AN 8-YEAR FOLLOW-UP STUDY

 

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https://storage.unitedwebnetwork.com/files/1099/92f8f9e2bd8a11430669a3c98d3a3454.pdf
SuPAR AND IgM-uria IMPROVES PREDICTION OF PROGRESSION OF EARLY CKD1-3. AN 8-YEAR FOLLOW-UP STUDY

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Omran
Bakoush
Omran Bakoush Omran.Bakoush@uaeu.ac.ae UAEU Internal Medicine AlAin United Arab Emirates *
Ali Al Dhanhani a.aldhanhani@uaeu.ac.ae UAEU Internal Medicine AlAin United Arab Emirates -
Abderrahim Oulhaj aoulhaj@uaeu.ac.ae Khalifa University Public Heath and Epidemiology Abu Dhabi United Arab Emirates -
Hassan Abboudi 201306072@uaeu.ac.ae UAEU Internal Medicine AlAin United Arab Emirates -
FATIMA AL AMERI 201202565@uaeu.ac.ae UAEU Internal Medicine AlAin United Arab Emirates -
AYA BIN TALEB 201205520@uaeu.ac.ae UAEU Internal Medicine AlAin United Arab Emirates -
Amal Khouri 201109009@uaeu.ac.ae UAEU Internal Medicine AlAin United Arab Emirates -
May Baniyas 201306180@uaeu.ac.ae UAEU Internal Medicine AlAin United Arab Emirates -
Javed Yasin javed.yasin@uaeu.ac.ae UAEU Internal Medicine AlAin United Arab Emirates -
Ghada Albluwi ghadabluwi@uaeu.ac.ae UAEU Internal Medicine AlAin United Arab Emirates -
Ahmad Alkrinat ahmad_alkrinat@uaeu.ac.ae UAEU Internal Medicine AlAin United Arab Emirates -
Mohamed Ismail mismail.65@gmail.com UAEU Internal Medicine AlAin United Arab Emirates -
 
 
 

Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular complications and kidney failure. In early-stage CKD (stages 1–3), standard clinical biomarkers such as estimated glomerular filtration rate (eGFR) and albuminuria may be less sensitive in assessing individual risk of kidney disease progression. Biomarkers of chronic inflammation, such as soluble urokinase plasminogen activator receptor (suPAR), and markers of glomerular capillary wall dysfunction, such as IgM-uria, may offer added value in improving CKD risk stratification. This study aimed to investigate the prognostic utility of suPAR and IgM-uria compared to current standard biomarkers (eGFR and urine albumin-to-creatinine ratio [ACR]).

This prospective cohort study included a consecutive sample of patients with CKD stages 1–3 who were recruited from a medical specialty outpatient clinic between July 1, 2012, and June 16, 2016. Participants were followed for approximately 11 years, until December 2023, to assess the primary outcomes. Serum creatinine and spot urine ACR were measured and collected at baseline while eGFR, cardiovascular outcomes were retrieved from electronic medical records. End-stage kidney disease (ESKD) and mortality status were confirmed via Abu Dhabi health exchange platform Malafi.
Major adverse cardiovascular outcomes (MACEs) included a composite of myocardial infarction (MI), unstable angina (UA), stroke, transient ischemic attack (TIA), or death due to cardiovascular disease. Kidney failure outcomes were defined as progression to ESKD, CKD stage 5, or a sustained decline in eGFR ≥40%.

The median follow-up was 7.9 years. suPAR and eGFR were significantly associated with increased risk of cardiovascular adverse outcomes (p <0.01). After adjustment for age, sex, and number of comorbidities, suPAR remained a significant predictor of cardiovascular outcomes (p <0.05). A one standard deviation (SD) increase in suPAR was associated with a 24% increased risk of CVD (HR: 1.24; 95% CI: 1.01–1.52; p = 0.037).  After adjusting for baseline eGFR, demographics and comorbidities, only IgM-uria remained a significant predictor of progression to kidney failure (p <0.01). A one SD increase in IgM-uria was associated with a 42% increased risk of kidney outcome (HR: 1.42; 95% CI: 1.15–1.76; p = 0.001).

suPAR and IgM-uria provided complementary prognostic information beyond eGFR and albuminuria. Implementing these biomarkers in clinical care pathways could facilitate earlier recognition and management of high-risk early CKD individuals.

Kewords