Table 2.
Cross-sectional Association between Urine Biomarkers of Kidney Tubule Injury and Dysfunction and Frailty in 2253 SPRINT Participants with CKD
| Frailty Index | ||||
|---|---|---|---|---|
| Biomarker | Frailty Continuous (range 0.007 – 0.559) | Fit (FI ≤ 0.10) | Less fit (0.10 < FI ≤ 0.21) | Frail (FI > 0.21) |
| (range 0.007 – 0.559) | OR (95% CI) | |||
| Log 2 IL-18, pg/mL | ||||
| Unadjusted | 0.01 (0.002, 0.01)*** | - | 1.05 (0.94, 1.18) | 1.17 (1.04, 1.32)* |
| Adjusteda | 0.003 (−0.0004, 0.01) | - | 1.06 (0.85, 1.31) | 1.12 (0.89, 1.41) |
| Adjusted + eGFR & albuminb | 0.002 (−0.002, 0.005) | - | 1.00 (0.79, 1.28) | 1.06 (0.82, 1.37) |
| Log 2 NGAL, ng/mL | ||||
| Unadjusted | 0.003 (0.001, 0.01)** | - | 1.05 (0.96, 1.14) | 1.13 (1.03, 1.24)** |
| Adjusteda | 0.001 (−0.001, 0.003) | 1.21 (1.01, 1.44)* | 1.23 (1.02, 1.49)* | |
| Adjusted + eGFR & albumin | −0.001 (−0.003, 0.002) | 1.14 (0.95, 1.37) | 1.13 (0.93, 1.38) | |
| Log 2 YKL-40, pg/mL | ||||
| Unadjusted | 0.001 (−0.0001, 0.003) | - | 0.97 (0.91, 1.04) | 1.01 (0.84, 1.08) |
| Adjusteda | 0.0003 (−0.002, 0.002) | 0.99 (0.87, 1.12) | 0.99 (0.86, 1.13) | |
| Adjusted + eGFR & albumin | 0.0002 (−0.002, 0.002) | 0.98 (0.85, 1.13) | 0.99 (0.85, 1.15) | |
| Log 2 KIM-1, pg/mL | ||||
| Unadjusted | 0.01 (0.003, 0.01)*** | - | 1.10 (1.01, 1.20)* | 1.19 (1.09, 1.31)*** |
| Adjusteda | 0.01 (0.003, 0.01)*** | 1.16 (0.99, 1.34) | 1.36 (1.14, 1.63)** | |
| Adjusted + eGFR & albuminb | 0.004, (0.001, 0.01)** | 1.09 (0.91, 1.30) | 1.22 (1.01, 1.49)* | |
| Log 2 MCP-1, pg/mL | ||||
| Unadjusted | 0.01 (0.003, 0.01)*** | - | 1.11 (0.99, 1.23) | 1.24 (1.10, 1.39)*** |
| Adjusteda | 0.01 (0.002, 0.01)*** | 1.12 (0.93, 1.36) | 1.37 (1.10, 1.69)** | |
| Adjusted + eGFR & albuminb | 0.004 (0.001, 0.01)** | 1.08 (0.87, 1.33) | 1.30 (1.04, 1.64)* | |
| Log 2 α1M, mg/g | ||||
| Unadjusted | 0.01 (0.005, 0.01)*** | - | 1.06 (0.94, 1.19) | 1.25 (1.11, 1.42)*** |
| Adjusteda | 0.01 (0.01, 1.02)*** | 1.41 (1.13, 1.75)** | 1.91 (1.50, 2.43)*** | |
| Adjusted + eGFR & albuminb | 0.01 (0.004, 0.01)*** | 1.18 (0.91, 1.54) | 1.48 (1.11, 1.96)** | |
| Log 2 β2M, ng/mL | ||||
| Unadjusted | 0.0004 (−0.0001, 0.002) | - | 0.98 (0.93, 1.04) | 1.00 (0.95, 1.06) |
| Adjusteda | 0.002 (0.0003, 0.003)* | 1.07 (0.98, 1.18) | 1.11 (1.00, 1.22)* | |
| Adjusted + eGFR & albuminb | 0.0004 (−0.001, 0.002) | 1.03 (0.93, 1.14) | 1.02 (0.92, 1.14) | |
| Log 2 Umod, ng/mL | ||||
| Unadjusted | −0.01 (−0.01, −0.01)*** | - | 0.99 (0.85, 1.15) | 0.80 (0.68, 0.93)** |
| Adjusteda | −0.01 (−0.01, −0.003)** | 1.04 (0.78, 1.38) | 0.90 (0.66, 1.22) | |
| Adjusted + eGFR & albuminb | −0.002 (−0.01, 0.002) | 1.26 (0.92, 1.73) | 1.30 (0.93, 1.82) | |
| Log 2 albumin, mg/L | ||||
| Unadjusted | 0.005 (0.003, 0.01)*** | - | 1.05 (0.98, 1.13) | 1.16 (1.08, 1.25)*** |
| Adjusteda | 0.005 (0.003, 0.01)*** | 1.20 (1.05, 1.37)** | 1.31 (1.14, 1.51)*** | |
| Adjusted + eGFR | 0.003 (0.001, 0.004)** | 1.12 (0.97, 1.29) | 1.15 (0.99, 1.34) | |
|
| ||||
Note.IL-18, interleukin-18; KIM-1, kidney injury molecule-1; NGAL, neutrophil gelatinase-associated lipocalin; MCP-1, monocyte chemoattractant protein-1; β2M, β2-microglobulin; α1M, α1-microglobulin; Umod, uromodulin.
a
Adjusted for age, race, sex, body mass index, alcohol use, years of education, insurance status, baseline systolic and diastolic blood pressure, smoking status, and urine creatinine.
B
Adjusted for all variables listed above and estimated glomerular filtration rate (eGFR) and Log2 albumin.
*
P<0.05;
**
P<0.01;
***
P<0.001