VALIDATION OF SERUM MYO-INOSITOL OXYGENASE AS A PREDICTOR OF CHRONIC KIDNEY DISEASE PROGRESSION IN PATIENTS WITH COMMUNITY-ACQUIRED ACUTE KIDNEY INJURY.

 

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VALIDATION OF SERUM MYO-INOSITOL OXYGENASE AS A PREDICTOR OF CHRONIC KIDNEY DISEASE PROGRESSION IN PATIENTS WITH COMMUNITY-ACQUIRED ACUTE KIDNEY INJURY.

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Annie
Dhiman
Annie Dhiman anniedhiman16@gmail.com Postgraduate Institute of Medical Education & Research sector 12 chandiagrh Experimental Medicine and Biotechnology chandiagrh India *
Jaskiran Kaur jaskiran265@gmail.com Postgraduate Institute of Medical Education & Research, sector 12 Chandiagrh Experimental Medicine and Biotechnology Chandiagrh India -
Dr. Arun Prabhahar arunprabhaharcmc@gmail.com Postgraduate Institute of Medical Education & Research, sector 12 Chandiagrh Department of Nephrology Chandiagrh India -
Dr. Vivek Kumar enigma165@gmail.com Postgraduate Institute of Medical Education & Research, sector 12 Chandiagrh Department of Nephrology Chandiagrh India -
Dr. Ashok Kumar Yadav mails2ashok@gmail.com Postgraduate Institute of Medical Education & Research, sector 12 Chandiagrh Experimental Medicine and Biotechnology Chandiagrh India -
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Acute kidney injury (AKI) substantially increases the risk of chronic kidney disease (CKD) and mortality. Evidence from developing countries, particularly for  community-acquired AKI (CA-AKI) is limited. Previously in a pilot study we have shown that levels of serum Myo-Inositol Oxygenase (MIOX) at the time of hospital discharge can be used as a prognostic biomarker for CKD progression after CA-AKI. We aimed to validate the MIOX level at the time of hospital discharge as a potential biomarker for CKD progression after CA-AKI.

Patients with CA-AKI, aged 18–70 years, without underlying CKD, were enrolled at hospital discharge. Serum samples were collected at discharge, and MIOX concentrations were measured using a commercial ELISA kit (USCN, Wuhan, China). Clinical and laboratory parameters were recorded at baseline and 4 months. Renal recovery was defined as eGFR ≥60 mL/min/1.73 m² at ≥3 months.

Of 3232 patients screened, 503 patients were enrolled, and 195 completed the 4-month follow‑up. At 4 months, 51 patients (26%) showed CKD progression. These patients had significantly higher discharge serum creatinine (5.37 vs. 3.52 mg/dL, p = 0.001), spot urine protein creatinine ratio (UPCR) (1293.5 vs. 340 mg/g, p<0.001), and serum MIOX levels (3817 pg/mL [IQR: 2846- 4318] vs. 2271.13 pg/mL [IQR: 1656.5- 2888], p < 0.001)  compared to those who recovered (Table 1). Higher serum MIOX levels were independently associated with CKD progression (OR 6.44, 95% CI 2.66-15.57; p < 0.001). Multivariable model including serum MIOX, discharge serum creatinine and discharge UPCR showed excellent prediction for the progression to CKD [AUC ROC 0.81; (95% CI 0.75, 0.88)] (Figure1).  

High serum MIOX at discharge predicts CKD progression in CA-AKI, suggesting its potential as a prognostic biomarker. 

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