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A Urinary Fragment of Mucin-1 Subunit ? Is a Novel Biomarker Associated With Renal Dysfunction in the General Population #MMPMID28920100
Kidney Int Rep 2017[Sep]; 2 (5): 811-20 PMID28920100show ga
Introduction: Sequencing peptides included in the urinary proteome identifies the parent proteins and may reveal mechanisms underlying the pathophysiology of chronic kidney disease. Methods: In 805 randomly recruited Flemish individuals (50.8% women; mean age, 51.1 years), we determined the estimated glomerular filtration rate (eGFR) from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. We categorized eGFR according to the National Kidney Foundation Kidney Disease Outcomes Quality Initiative guideline. We analyzed 74 sequenced urinary peptides with a detectable signal in more than 95% of participants. Follow-up measurements of eGFR were available in 597 participants. Results: In multivariable analyses, baseline eGFR decreased (P ? 0.022) with urinary fragments of mucin-1 (standardized association size expressed in ml/min/1.73 m2, ?4.48), collagen III (?2.84), and fibrinogen (?1.70) and was bi-directionally associated (P ? 0.0006) with 2 urinary collagen I fragments (+2.28 and ?3.20). The eGFR changes over 5 years (follow-up minus baseline) resulted in consistent estimates (P ? 0.025) for mucin-1 (?1.85), collagen (?1.37 to 1.43) and fibrinogen (?1.45) fragments. Relative risk of having or progressing to eGFR <60 ml/min/1.73 m2 was associated with mucin-1. Partial least-squares analysis confirmed mucin-1 as the strongest urinary marker associated with decreased eGFR, with a score of 2.47 compared with 1.80 for a collagen I fragment as the next contender. Mucin-1 predicted eGFR decline to <60 ml/min/1.73 m2 over and above microalbuminuria (P = 0.011) and retained borderline significance (P = 0.05) when baseline eGFR was accounted for. Discussion: In the general population, mucin-1 subunit ?, an extracellular protein that is shed from renal tubular epithelium, is a novel biomarker associated with renal dysfunction.