Elevated plasma soluble urokinase-type plasminogen activator receptor (suPAR) levels are associated with declines in estimated glomerular filtration rate (eGFR) and may predict progression to clinical chronic kidney disease, new research suggests.
Data from the Emory Cardiovascular Biobank – a prospective registry of 3,683 patients undergoing cardiac catheterization – showed individuals in the highest quartile of baseline suPAR had a significantly greater annual decline in eGFR than those in the lowest quartile (-4.2 mL/min per 1.73 m2 vs. -0.9mL/min per 1.73 m2).
Similarly, those in the highest suPAR quartile had a threefold greater risk of incident chronic kidney disease than those in the lowest quartile, independent of their race or diabetes status and excluding those with acute kidney injury, according to a paper presented at the meeting sponsored by the American Society of Nephrology and published simultaneously online in the Nov. 5 edition of the New England Journal of Medicine.
The relationship between elevated suPAR and eGFR decline was strongest in patients who had a normal eGFR at baseline (N Engl J Med. 2015 Nov 5 [doi:10.1056/NEJMoa1506362]).
Dr. Salim Hayek
The risk classification for chronic kidney disease using suPAR was greater than existing and well-established risk factors such as C-reactive protein and B-type natriuretic peptide, wrote Dr. Salim S. Hayek, from Emory University, Atlanta, Sanja Sever, Ph.D., of Harvard Medical School, Boston, and their coauthors.
“Our results suggest that suPAR meets critical requirements for a biomarker of chronic kidney disease,” the authors said.
The study was supported by the Abraham J. and Phyllis Katz Foundation, the Robert W. Woodruff Health Sciences Center Fund, Emory Heart and Vascular Center, and the National Institutes of Health. Several authors declared grants and personal fees and committee involvement with private industry, and patents relevant to the work.