Table 3.
Association of quartiles of kidney tubule injury markers with annualized relative change in eGFR in SPRINT
| Biomarkers | Mean eGFR Decline, %/yr | Model 1 | Model 2 | ||
|---|---|---|---|---|---|
| Urine IL-18 | Linear model | Per two-fold higher biomarker concentration |
−0.38 (−0.51 to −0.25) | −0.11 (−0.25 to 0.02) | |
| Quartiles | 1 | −1.06 (−1.36 to −0.76) | 0.0 (Reference) | 0.0 (Reference) | |
| 2 | −1.17 (−1.47 to −0.87) | −0.51 (−0.94 to −0.07)a | −0.06 (−0.49 to 0.37) | ||
| 3 | −1.75 (−2.05 to −1.45) | −1.38 (−1.83 to −0.92) | −0.81 (−1.26 to − 0.35)a | ||
| 4 | −1.77 (−2.08 to −1.46) | −1.88 (−2.38 to −1.36) | −0.91 (−1.44 to −0.38)a | ||
| Urine KIM-1 | Linear model | Per two-fold higher biomarker concentration |
−0.29 (−0.40 to −0.18) | 0.06 (−0.05 to 0.17) | |
| Quartiles | 1 | −1.09 (−1.39 to −0.79) | 0.0 (Reference) | 0.0 (Reference) | |
| 2 | −1.95 (−2.25 to −1.65) | −1.33 (−1.30 to −0.44) | −0.54 (−0.98 to −0.09)a | ||
| 3 | −1.21 (−1.51 to −0.91) | −0.83 (−1.32 to −0.35)a | 0.17 (−0.32 to 0.66) | ||
| 4 | −1.48 (−1.79 to −1.17) | −1.65 (−2.21 to −1.08) | −0.21 (−0.80 to 0.38) | ||
| Urine NGAL | Linear model | Per two-fold higher biomarker concentration |
−0.14 (−0.24 to −0.04) | 0.10 (0.01 to 0.21)a | |
| Quartiles | 1 | −1.33 (−1.64 to −1.03) | 0.0 (Reference) | 0.0 (Reference) | |
| 2 | −1.49 (−1.78 to −1.19) | −0.35 (−0.79 to 0.08) | −0.30 (−0.13 to 0.74) | ||
| 3 | −0.91 (−1.21 to −0.61) | 0.24 (−0.22 to 0.69) | 0.80 (−0.35 to 1.25) | ||
| 4 | −2.04 (−2.35 to −1.73) | −0.91 (−1.39 to −0.44) | 0.27 (−0.21 to 0.76) | ||
| Urine MCP-1 | Linear model | Per two-fold higher biomarker concentration |
−0.23 (−0.36 to −0.11) | 0.07 (−0.05 to 0.20) | |
| Quartiles | 1 | −1.26 (−1.56 to −0.96) | 0.0 (Reference) | 0.0 (Reference) | |
| 2 | −1.34 (−1.64 to −1.04) | −0.39 (−0.83 to 0.06) | 0.28 (−0.16 to 0.73) | ||
| 3 | −1.64 (−1.95 to −1.34) | −1.03 (−1.53 to −0.54) | −0.19 (−0.68 to 0.31) | ||
| 4 | −1.48 (−1.79 to −1.17) | −1.25 (−1.83 to −0.67) | −0.17 (−0.76 to 0.42) | ||
| Urine YKL-40 | Linear model | Per two-fold higher biomarker concentration |
−0.14 (−0.22 to −0.07) | 0.03 (−0.11 to 0.04) | |
| Quartiles | 1 | −1.61 (−1.90 to −1.32) | 0.0 (Reference) | 0.0 (Reference) | |
| 2 | −0.83 (−1.14 to −0.52) | 0.60 (0.16 to 1.04) | 0.41 (−0.02 to 0.84) | ||
| 3 | −1.30 (−1.61 to −1.00) | 0.01 (−0.45 to 0.46) | 0.02 (−0.43 to 0.46) | ||
| 4 | −1.97 (−2.28 to −1.66) | −0.83 (−1.30 to −0.33) | −0.11 (−0.61 to 0.38) | ||
| Urine albumin | Linear model | Per two-fold higher biomarker concentration |
−0.79 (−0.86 to −0.71) | −0.67 (−0.75 to −0.59)a | |
| Quartiles | 1 | −0.30 (−0.59 to −0.01) | 0.0 (Reference) | 0.0 (Reference) | |
| 2 | −0.60 (−0.89 to −0.31) | −0.67 (−1.09 to −0.24)a | −0.40 (−0.83 to 0.03) | ||
| 3 | −1.38 (−1.68 to −1.07) | −1.50 (−1.94 to −1.05) | −1.08 (−1.53 to −0.63)a | ||
| 4 | −3.68 (−3.98 to −3.37) | −3.75 (−4.19 to −3.32) | −3.05 (−3.51 to −2.59)a |
Model 1: adjusted for age, sex, race, intervention arm, and urine creatinine. Model 2: additionally adjusted for baseline eGFR, urine albumin, smoking status, history of cardiovascular disease, baseline number of antihypertensive medications, systolic BP, diastolic BP, body mass index, HDL, and total cholesterol. Urine IL-18, pg/ml (quartile 1: ≤16.30; quartile 2: 16.31–30.48; quartile 3: 30.49–56.60; quartile 4: >56.60), urine KIM-1, pg/ml (quartile 1: ≤386.73; quartile 2: 386.74–849.01; quartile 3: 849.02–1595.84; quartile 4: >1595.84), urine NGAL, ng/ml (quartile 1: ≤14.71; quartile 2: 14.72–27.69; quartile 3: 27.70–59.27; quartile 4: >59.27), urine MCP-1, pg/ml (quartile 1: ≤89.42; quartile 2: 89.43–180.78; quartile 3: 180.79–326.99; quartile 4: >326.99), urine YKL-40, pg/ml (quartile 1: ≤213.95; quartile 2: 213.96–542.59; quartile 3: 542.60–1243.42; quartile 4: >1243.42), and urine albumin mg/dl (quartile 1: ≤7; quartile 2: 8–16; quartile 3: 17–50, quartile 4: >50). SPRINT, Systolic Blood Pressure Intervention Trial; KIM-1, kidney injury molecule-1; NGAL, neutrophil gelatinase-associated lipocalin; MCP-1, monocyte chemo attractant protein-1; YKL-40, chitinase-3-like protein-1.
Represents significant results.