Low Urinary Uromodulin Predicts Worse Kidney Outcomes
Patients in the lowest quartiles of urinary uromodulin had increased risks of end-stage renal disease and rapid kidney function decline.
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NEW ORLEANS—Urinary uromodulin, which is secreted by the ascending limb of the loop of Henle, independently predicts development of end-stage renal disease (ESRD) and rapid kidney function decline in patient with chronic kidney disease, according to data presented at the American Society of Nephrology's Kidney Week 2017 meeting.
Dominik Steubl, MD, of Klinikum rechts der Isar in Munich, Germany, and other members of the Munich Uromodulin Study Group, evaluated urinary uromodulin, estimated glomerular filtration rate (eGFR), proteinuria, and demographic and treatment parameters in 230 patients with stage 1-5 CKD. During a follow-up of 57.3 weeks, 47 patients (20.4%) experienced ESRD or rapid kidney function decline. Patient in the lowest quartile of urinary uromodulin (2.6 µg/mL or below) and second lowest quartile (2.7–4.75 ug/mL) had a significant 3.6-fold and 5.4-fold greater risk for ESRD or rapid eGFR loss, respectively, compared with patients in the highest quartile (11.45 µg/mL or higher), the investigators reported.
At an optimal cut off of 3.5 µg/mL, urinary uromodulin predicted the endpoint with 74.6% sensitivity and 76.6% specificity, with an area under the curve of 0.786.
The authors concluded that urinary uromodulin “might serve as a robust predictor of rapid kidney function decline and help to better schedule arrangements for future treatment.”
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Steubl D. Urinary uromodulin independently predicts ESRD and rapid kidney function decline in CKD patients. Presented in poster format at Kidney Week 2017 in New Orleans (Oct. 31-Nov. 5). Poster FR-PO390.