Sarah Schrauben, MD, MSCE, and colleagues in the Chronic Kidney Disease (CKD) Biomarkers Consortium performed a case-cohort study with 898 patients in the Chronic Renal Insufficiency Cohort who had diabetes and an eGFR below 60 mL/min/1.73 m2 to examine if urine biomarkers linked to tubulointerstitial health (monocyte chemoattractant protein-1 (MCP-1), kidney injury molecule-1 (KIM-1), alpha-1-microglobulin, epidermal growth factor (EGF) and uromodulin) may identify worsening of kidney health or CKD progression, defined as incident end-stage kidney disease or eGFR decline of 40% or greater from baseline. Participants were followed for 7.35 years.
Results indicate higher levels of KIM-1 and MCP-1 were associated with increased CKD progression risk, and higher urine levels of EGF were linked to lower risk of progression. These findings support that urine levels of MCP-1, KIM-1 and EGF may be used to noninvasively assess tubule and interstitial health in patients with CKD and diabetes. The study was also featured in Healio, which highlighted its potential impact on diabetic kidney disease monitoring.