ArticleJournal of the American Society of Nephrology : JASN2013
Analysis of a urinary biomarker panel for incident kidney disease and clinical outcomes.
Article in Journal of the American Society of Nephrology : JASN, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Recent Advances in Urinary Peptide and Proteomic Biomarkers in Chronic Kidney Disease: A Systematic Review.International journal of molecular sciences · 2023Pooled it
- Are Urinary Tubular Injury Markers Useful in Chronic Kidney Disease? A Systematic Review and Meta Analysis.PloS one · 2016Pooled it
- Markers of kidney tubule function and risk of cardiovascular disease events and mortality in the SPRINT trial.European heart journal · 2019Trial
- Urine Injury Biomarkers and Risk of Adverse Outcomes in Recipients of Prevalent Kidney Transplants: The Folic Acid for Vascular Outcome Reduction in Transplantation Trial.Journal of the American Society of Nephrology : JASN · 2016Trial
- Proximal tubule reabsorptive dysfunction and risk of cardiovascular death among community-living adults: the HUNT-3 cohort.European heart journal open · 2026Article
- Oxidative Stress-Driven Mechanisms and Biomarkers of Drug-Induced Nephrotoxicity: Translational Insights and Therapeutic Implications.Antioxidants (Basel, Switzerland) · 2026Review
- Urine as a source of biomarkers and biological knowledge in chronic kidney disease.Nature reviews. Nephrology · 2026Review
- Plasma and Urinary KIM-1 in Chronic Kidney Disease: Prognostic Value, Associations with Albuminuria, and Implications for Kidney Failure and Mortality.American journal of nephrology · 2025Article
- Emerging multisystem biomarkers in hereditary transthyretin amyloidosis: a pilot study.Scientific reports · 2024Article
- The urine-to-plasma urea concentration ratio is associated with eGFR and eGFR decline over time in a population cohort.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023Article
- Protein Biomarkers in Chronic Kidney Disease in Children-What Do We Know So Far?Journal of clinical medicine · 2023Review
- Elevated urinary alpha-1 microglobulin levels are associated with decreased survival among chronic kidney disease patients: a real-world population study.Journal of nephrology · 2023Article
- Derivation and validation of urinary TIMP-1 for the prediction of acute kidney injury and mortality in critically ill children.Journal of translational medicine · 2022Article
- Plasma and Urine Biomarkers of CKD: A Review of Findings in the CKiD Study.Seminars in nephrology · 2021Review
- Urine Alpha-1-Microglobulin Levels and Acute Kidney Injury, Mortality, and Cardiovascular Events following Cardiac Surgery.American journal of nephrology · 2021Article
- 70-year legacy of the Framingham Heart Study.Nature reviews. Cardiology · 2019Review
- Biomarkers of Drug-Induced Kidney Toxicity.Therapeutic drug monitoring · 2019Review
- Urinary Cysteine-Rich Protein 61 and Trefoil Factor 3 as Diagnostic Biomarkers for Colorectal Cancer.Translational oncology · 2019Article
- The Association of Serum hsCRP and Urinary Alpha1-Microglobulin in Patients with Type 2 Diabetes Mellitus.BioMed research international · 2019Article
- Associations of Urine Biomarkers with Kidney Function Decline in HIV-Infected and Uninfected Men.American journal of nephrology · 2019Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 3 countries.
Funding
Abstract
Whether novel biomarkers improve the assessment of incident kidney disease and related adverse outcomes remains to be tested in longitudinal observational studies. We tested 14 urinary biomarkers for association with incident kidney, cardiovascular, and mortality outcomes in 2948 Framingham Heart Study participants. Baseline examinations were performed between 1995 and 1998; mean follow-up was 10.1 years for renal outcomes and 11.2 years for survival analyses. Primary outcomes were incident CKD, incident albuminuria, incident cardiovascular disease, and all-cause mortality. Secondary analyses assessed incident congestive heart failure (CHF) and mortality with coexistent kidney disease. Biomarkers were tested for association with renal end points using logistic regression and incident cardiovascular and mortality outcomes in proportional hazards models; α1-microglobulin, Kim-1, and TFF-3 predicted all-cause mortality (hazard ratio per SD increase in log-transformed biomarker [HR] range, 1.15 to 1.21; 95% confidence interval [CI] range, 1.04 to 1.34; P values=0.007 to <0.001), whereas α1-microglobulin, β2-microglobulin, KIM-1, and TFF-3 associated with death with coexistent kidney disease (HR range, 1.72-2.25; 95% CI, 1.17 to 3.24; P values<0.01). KIM-1 also associated with the risk of incident CHF (HR, 1.32; 95% CI, 1.07 to 1.63; P=0.008). CTGF associated nominally with CKD (HR, 0.83; 95% CI, 0.71 to 0.98; P=0.03), but no other biomarkers associated with incident CKD or albuminuria. Addition of α1-microglobulin and TFF-3 resulted in a nonsignificant net reclassification index (NRI) of 3% for all-cause mortality beyond clinical risk factors. In conclusion, components of a panel of 14 subclinical biomarkers of kidney injury were associated with important clinical outcomes and merit additional investigation.
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Registered trials
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