Kidney Failure in the Elderly Linked to Low Serum Uromodulin
In a study of 933 individuals with a mean age of 78 years, higher serum uromodulin was associated with a lower risk of end-stage renal disease.
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SAN DIEGO—Low serum levels of uromodulin (sUMOD) may predict an increased risk of end-stage renal disease (ESRD) among elderly individuals, study findings presented at the American Society of Nephrology's Kidney Week 2018 meeting suggest.
The study, which included 933 individuals with a mean age of 78 years who participated in the Cardiovascular Health Study, demonstrated that each 1 standard deviation increase in sUMOD level was associated with a significant 63% reduced risk of ESRD in multivariable analysis, investigators Dominik Steubl, MD, of Tufts Medical Center in Boston, and colleagues reported in a poster presentation..
Kidney function decline occurred in 179 individuals. In demographic-adjusted analyses, higher sUMOD was associated with significantly reduced odds of kidney function decline. In multivariable analysis, however, the association was attenuated and no longer significant.
Uromodulin is released by into the serum by tubular epithelial cells, “and lower levels are associated with more severe tubular atrophy and interstitial fibrosis (IF/TA),” Dr Steubl and his collaborators explained in their poster. “However, little is known about the association of sUMOD with long-term kidney outcomes in the elderly, a population with a high prevalence of IF/TA.”
The study population was 40% male and 15% non-white. The mean sUMOD level was 127 ng/mL and estimated glomerular filtration rate (eGFR) was 63 mL/min/1.73 m2. ESRD developed in 53 participants during a median follow-up of 9.9 years.
In a study presented at the Kidney Week meeting in 2017, Dr Steubl and colleagues showed that low levels of urinary uromodulin were associated with increased risks of ESRD and rapid renal function decline in patients with chronic kidney disease. Patients in the lowest and second-lowest quartile of urinary uromodulin had a significant 3.6- and 5.4-fold greater risk of ESRD or rapid eGFR loss, respectively, compared with patients in the highest quartile.
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Steubl D, Buzkova P, Garimella PS, et al. Association of serum uromodulin with ESRD and kidney function decline in the elderly—The Cardiovascular Health Study. Presented at the American Society of Nephrology's 2018 Kidney Week meeting in San Diego, Oct. 23-28. Abstract FR-PO170.