Observational studyAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2021
Biomarkers of Kidney Tubule Health, CKD Progression, and Acute Kidney Injury in SPRINT (Systolic Blood Pressure Intervention Trial) Participants.
Observational study in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Urinary Biomarkers Of Kidney Function As Predictors Of Cardiovascular Health: A Systematic Review.Current hypertension reports · 2025Pooled it
- Phenotyping Kidney Function in Young Adults With High Blood Pressure: The African-PREDICT Study.Journal of clinical hypertension (Greenwich, Conn.) · 2024Trial
- Absence of Kidney Tubular Injury in Patients With Acute Heart Failure With Acute Kidney Injury.Circulation. Heart failure · 2024Trial
- Association of Kidney Tubule Dysfunction and Injury Biomarkers With Long-term Risk of Acute Kidney Injury During Acute Congestive Heart Failure Hospitalizations.Kidney medicine · 2026Article
- Water intake mediates cross-sectional associations between urinary kidney injury biomarkers and race in emerging adults.American journal of physiology. Regulatory, integrative and comparative physiology · 2026Article
- Urinary macrophage migration inhibitory factor predicts kidney failure in advanced CKD patients.BMC nephrology · 2026Article
- Associations of repeated measures of plasma biomarkers of kidney tubular health with longitudinal kidney function in people with HIV.AIDS (London, England) · 2026Article
- Article
- Defining Kidney Health Dimensions and Their Associations with Adverse Outcomes in Persons with Diabetes and CKD.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- Associations of Urine Epidermal Growth Factor With Kidney and Cardiovascular Outcomes in Individuals With CKD in SPRINT.Kidney international reports · 2024Article
- Urine Epidermal Growth Factor and Kidney Function Decline in Middle-Aged Adults.Kidney medicine · 2024Article
- Clinical significance of amphiregulin in patients with chronic kidney disease.Clinical and experimental nephrology · 2024Article
- Fibrosis in Chronic Kidney Disease: Pathophysiology and Therapeutic Targets.Journal of clinical medicine · 2024Review
- Clusters of Body Fat and Nutritional Parameters are Strongly Associated with Diabetic Kidney Disease in Adults with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024Article
- Article
- 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
- External Validation of a Urinary Biomarker Risk Score for the Prediction of Steroid Responsiveness in Adults With Nephrotic Syndrome.Kidney international reports · 2023Article
- Markers of Kidney Tubular Function Deteriorate While Those of Kidney Tubule Health Improve in Primary Aldosteronism After Targeted Treatments.Journal of the American Heart Association · 2023Article
- APOC1 as a novel diagnostic biomarker for DN based on machine learning algorithms and experiment.Frontiers in endocrinology · 2023Article
- Role of MCP-1 as an inflammatory biomarker in nephropathy.Frontiers in immunology · 2023Review
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
RATIONALE &
objectiveThe Systolic Blood Pressure Intervention Trial (SPRINT) compared the effect of intensive versus standard systolic blood pressure targets on cardiovascular morbidity and mortality. In this ancillary study, we evaluated the use of exploratory factor analysis (EFA) to combine biomarkers of kidney tubule health in urine and plasma and then study their role in longitudinal estimated glomerular filtration rate (eGFR) change and risk of acute kidney injury (AKI). STUDY
designObservational cohort nested in a clinical trial. SETTING &
participants2,351 SPRINT participants with eGFR < 60 mL/min/1.73 m EXPOSURE: Levels of neutrophil gelatinase-associated lipocalin (NGAL), interleukin 18 (IL-18), chitinase-3-like protein (YKL-40), kidney injury molecule 1 (KIM-1), monocyte chemoattractant protein 1 (MCP-1), α OUTCOME: Longitudinal changes in eGFR and risk of AKI. ANALYTICAL APPROACH: We performed EFA to capture different tubule pathophysiologic processes. We used linear mixed effects models to evaluate the association of each factor with longitudinal changes in eGFR. We evaluated the association of the tubular factors scores with AKI using Cox proportional hazards regression.
resultsFrom 10 biomarkers, EFA generated 4 factors reflecting tubule injury/repair (NGAL, IL-18, and YKL-40), tubule injury/fibrosis (KIM-1 and MCP-1), tubule reabsorption (A1M and B2M), and tubule reserve/mineral metabolism (UMOD, FGF-23, and PTH). Each 1-SD higher tubule reserve/mineral metabolism factor score was associated with a 0.58% (95% CI, 0.39%-0.67%) faster eGFR decline independent of baseline eGFR and albuminuria. Both the tubule injury/repair and tubule injury/fibrosis factors were independently associated with future risk of AKI (per 1 SD higher, HRs of 1.18 [95% CI, 1.10-1.37] and 1.23 [95% CI, 1.02-1.48], respectively). LIMITATIONS: The factors require validation in other settings.
conclusionsEFA allows parsimonious subgrouping of biomarkers into factors that are differentially associated with progressive eGFR decline and AKI. These subgroups may provide insights into the pathological processes driving adverse kidney outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.