Urinary Retinol-Binding Protein: Relationship to Renal Function and Cardiovascular Risk Factors in Chronic Kidney Disease

Author(s)

Muniz Domingos, Maria Alice ; Moreira, Silvia Regina ; Gomez, Luz ; Goulart, Alessandra ; Lotufo, Paulo Andrade ; Bensenor, Isabela ; Titan, Silvia

• Document type: Journal article
• Source: PLoS One; v. 11, n. 9 SEP 21 2016.
• Web of Science Citations: 5

Abstract

The role of urinary retinol-binding protein (RBP) as a biomarker of CKD in proximal tubular diseases, glomerulopathies and in transplantation is well established. However, whether urinary RBP is also a biomarker of renal damage and CKD progression in general CKD is not known. In this study, we evaluated the association of urinary RBP with renal function and cardiovascular risk factors in the baseline data of the Progredir Study, a CKD cohort in Sao Paulo, Brazil, comprising 454 participants with stages 3 and 4 CKD. In univariate analysis, urinary RBP was inversely related to estimated glomerular filtration rate (CKD-EPI eGFR) and several cardiovascular risk factors. After adjustments, however, only CKD-EPI eGFR, albuminuria, systolic blood pressure, anemia, acidosis, and left atrium diameter remained significantly related to urinary RBP. The inverse relationship of eGFR to urinary RBP (beta-0.02 +/- 95CI -0.02; -0.01, p<0.0001 for adjusted model) remained in all strata of albuminuria, even after adjustments: in normoalbuminuria (beta-0.008 +/- 95CI (-0.02; -0.001, p = 0.03), in microalbuminuria (beta-0.02 +/- 95CI (-0.03; -0.02, p<0,0001) and in macroalbuminuria (beta-0.02 +/- 95CI (-0.03; -0.01, p<0,0001). Lastly, urinary RBP was able to significantly increase the accuracy of a logistic regression model (adjusted for sex, age, SBP, diabetes and albuminuria) in diagnosing eGFR<35 ml/min/1.73m(2) (AUC 0,77, 95% CI 0,72-0,81 versus AUC 0,71, 95% CI 0,65-0,75, respectively; p = 0,05). Our results suggest that urinary RBP is significantly associated to renal function in CKD in general, a finding that expands the interest in this biomarker beyond the context of proximal tubulopathies, glomerulopathies or transplantation. Urinary RBP should be further explored as a predictive marker of CKD progression. (AU)

• FAPESP's process: 11/17341-0 - Chronic kidney disease: determinants of progression and cardiovascular risk: a cohort study in a brazilian population
• Grantee: Silvia Maria de Oliveira Titan
• Support Opportunities: Regular Research Grants