Researchers identify most studied biomarkers in the setting of CKD
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Investigators identified tumor necrosis factor receptor 1 as the most frequently studied plasma biomarker in the setting of chronic kidney disease progression.
They found kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin both served as the most studied urine biomarkers.
“The last decade has seen a lot of work on various biomarkers to help prognosticate CKD progression, but heretofore, the findings on the performance of the biomarkers (adjusted for standard clinical predictor variables), had not been formally assessed,” Steven G. Coca, DO, MS, a professor medicine and associate chair of clinical and translational research in the department of medicine at Icahn School of Medicine at Mount Sinai, told Healio.
To address this gap, Coca and colleagues performed a systematic review and meta-analysis on studies that evaluated the relationship between baseline kidney biomarkers and CKD outcomes. All studies were derived from Embase, MEDLINE ALL and Scopus up to Nov. 30, 2020.
Researchers measured publication bias through funnel plots and used the Derimonian and Laird method with inverse-variance random-effects models to estimate heterogeneity.
Of the 26,456 abstracts and 352 full-text articles screened, 129 were included in the meta-analysis. Analyses revealed the 12 most studied plasma biomarkers in the setting of CKD were as follows: tumor necrosis factor receptor 1 (TNFR1; n=31), fibroblast growth factor-23 (FGF23; n=30), TNFR2 (n=23), kidney injury molecule-1 (KIM-1; n=18), soluble urokinase plasminogen activator receptor (suPAR; n=12), 5, growth differentiation factor- 15 (GDF-15; n=8), IL-6 (n=8), uromodulin (UMOD; n=7), galectin-3 (n=6), endostatin (n=5), monocyte chemoattractant protein-1 (MCP-1; n=5) and YKL-40 (n=5).
The pooled relative risks for CKD outcomes were 2.17 for TNFR1, 1.21 for FGF-23, 2.07 for TNFR2, 1.51 for KIM-1 and 1.42 for suPAR.
Similarly, the 12 most studied urine biomarkers were as follows: KIM-1 (n=19 studies), neutrophil gelatinase-associated lipocalin (NGAL; n=19), liver-type fatty acid binding protein (n=8), alpha-1-microglobulin (n=8), uromodulin (n=8), epidermal growth factor (n=7), IL-18 (n=6), beta 2 microglobulin (n=6), N-acetyl-beta-D-glucosaminidase (n=6), MCP-1 (n=5), YKL-40 (n=3) and CKD273 (n=2). Researchers identified the pooled relative risks were 1.10 for KIM-1 and 1.12 for NGAL.
“These findings help shine light on which biomarkers have been the most widely studied, and which biomarkers to date seem to be providing the strongest prognostic signals above and beyond the clinical variables. These findings help guide the medical community on which biomarkers should be considered when assessing the performance of newly discovered biomarkers, and which biomarkers can be largely ignored for future work or consideration.”
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