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Serum uromodulin predicts a decline in kidney function independently from the presence of type 2 diabetes

Session Poster session 6

Speaker Christoph Saely

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Acute Coronary Syndromes: Biomarkers
  • Session type : Poster Session

Authors : A Leiherer (Feldkirch,AT), A Muendlein (Feldkirch,AT), CH Saely (Triesen,LI), EM Brandtner (Feldkirch,AT), K Geiger (Feldkirch,AT), A Schuler (Feldkirch,AT), P Schwerzler (Triesen,LI), A Mader (Triesen,LI), P Fraunberger (Feldkirch,AT), H Drexel (Philadelphia,US)

A. Leiherer1 , A. Muendlein1 , C.H. Saely2 , E.M. Brandtner1 , K. Geiger1 , A. Schuler3 , P. Schwerzler2 , A. Mader2 , P. Fraunberger4 , H. Drexel5 , 1VIVIT Institute - Feldkirch - Austria , 2Private University of the Principality of Liechtenstein - Triesen - Liechtenstein , 3Academic Teaching Hospital, Department of Medicine and Cardiology - Feldkirch - Austria , 4Medical Central Laboratory - Feldkirch - Austria , 5Drexel University College of Medicine - Philadelphia - United States of America ,

European Heart Journal ( 2017 ) 38 ( Supplement ), 1128

Introduction: Uromodulin is the most abundant protein excreted in urine. Low uromodulin has been found to be associated with type 2 diabetes (T2DM) as well as with chronic kidney disease (CKD).

Purpose: The purpose of this study was to investigate whether serum uromodulin also predicts a future decline in kidney function.

Methods: We measured serum uromodulin in 529 patients undergoing coronary angiography for the evaluation of established or suspected coronary artery disease (CAD).

Results: Uromodulin was lower in patients with T2DM than in nondiabetic subjects (148±70 vs. 171±79; p=0.001) and significantly correlated with estimated glomerular filtration rate (eGFR; r=0.242, p<0.001) and, inversely, with the albumin creatinine ratio (ACR; r=-0.120, p=0.012). It was significantly lower in patients with CKD (eGFR <60 ml/min/1.73 m2) than in those with normal kidney function (72±29 vs. 169±76 ng/ml; p<0.001), and also in patients with albuminuria than in patients without increased albumin excretion (149±72 vs. 168±78 ng/ml; p=0.008). Further, uromodulin at baseline was significantly lower in patients who developed an eGFR <60 ml/min/1.73 m2 during 4 years of follow-up compared to those who did not (127±42 vs. 180±79ng/ml, p=0.003). It was inversely associated with declining eGFR even after full adjustment including ACR, baseline CAD and the presence of T2DM (OR=0.354 [95% CI 0.131–0.957], p=0.041). The inclusion of uromodulin to a basic prediction model for CKD increased the model performance (C-statistic 0.844 vs. 0.804, p=0.049).

Conclusion: In conclusion, we for the first time show that serum uromodulin predicts a decline in kidney function independently from conventional risk factors including T2DM.

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