Tue Sep 20 2022

Soluble urokinase plasminogen activator receptor and decline in kidney function among patients without kidney disease

Conclusion

Patients who arrived at the emergency department and showed higher levels of suPAR experienced a faster decline in eGFR, indicating kidney disease. This finding implies that measuring suPAR levels routinely could be useful for early kidney disease detection.

Background

Hospitalized patients are at increased risk for kidney disease post-discharge, even without evident symptoms. The soluble urokinase plasminogen activator receptor (suPAR) indicates chronic inflammation, detectable via blood tests. Our research investigates whether high suPAR levels during hospital stays can predict post-discharge eGFR declines, indicating kidney function deterioration.

Methods

We conducted a retrospective, longitudinal cohort study on patients visiting the emergency department twice within three years, initially free from kidney disease. The goal was to examine the link between suPAR levels and eGFR decline. We employed linear mixed models for repeated measures, adjusting for age, sex, C-reactive protein, sodium levels, and existing conditions like diabetes, hypertension, or cardiovascular disease.

Results

The study analyzed 5,124 patients, median age 65.9, with females making up 51.0%. The median suPAR was 2.9 ng/mL. The average time to readmission was 144 days, with a predicted eGFR fall of 5.1 mL/min/1.73 m^2 annually. After adjusting for risk factors, we found eGFR decreases of 4.3, 5.2, or 9.0 mL/min/1.73 m^2 per year in patients with suPAR levels under 3, between 3 and 6, or over 6 ng/mL, respectively. Grouping suPAR levels into tertiles—lowest (<2.4 ng/mL), middle (2.4–3.6 ng/mL), and highest (≥3.6 ng/mL)—showed eGFR declines of 4.2, 4.6, or 6.5 mL/min/1.73 m^2 yearly, respectively. Higher suPAR consistently indicated quicker eGFR reduction, significantly (P < .001).

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published suPAR studies in leading medical journals

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