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Table 3 Associations between stage II biomarkers and renal outcomes

From: Biomarkers for the detection of renal fibrosis and prediction of renal outcomes: a systematic review

Reference

Biomarker/cut off

Patient Population

Subjects N (%)*

Definition of renal progression

Follow up: Median (range) Mean (± SD)

Point Estimate (95% CI; p-value)

C-statistic or AUC/specificity/sensitivity

Quality Score

Chen et al [29]

Urine TGF-β > 569 ng/l

Unilateral ureteral obstruction requiring percutaneous nephrostomy

45 (24)

Non-functioning kidney group defined by no improvement in eGFR

3 months

NR

NR/82%/82%

Fair (7)

Harris et al [30]

Blood TGF- β

Renal transplant recipients

100 (23)

Biopsy proven chronic allograft nephropathy using Banff 97

5 years

HR 1.7 (1.1-2.6; p = 0.008)

NR/NR/NR

Good (10)

Wong et al [31]

Blood total TGF- β 1

Blood active TGF- β 1

Type II diabetes

102

179 (HC)

Doubling of serum creatinine

5 years

Blood total TGF- β 1: OR 3.9 (2.1-7.3)

Conventional predictors:a 0.75/NR/NR

Fair (7)

Blood active TGF- β 1: NR

Addition of total TGF-β1: 0.82/NR/NR

 

Addition of active TGF-β1: 0.88/NR/NR

Addition of both active and total TGF- β 1: 0.96/NR/NR

Hsu et al [27]

Blood MMP-2

Non diabetic patients referred for coronary angiography

251 (16)

eGFR decline >25% from baseline

8.5 (±2.4) years

HR 2.5 (1.2-5.1)

NR/NR/NR

Good (9)

Shi et al [28]

Urine MMP-2

Chronic tubulointerstitial nephropathy

61

20 (HC)

Continuous outcome of eGFR decline

38 (11-54) months

β coefficient

-0.1 ml/min/m2, (p = 0.05)

0.74 (p < 0.05)/NR/NR

Fair (7)

Titan et al [32]

Urine MCP-1 ≥ 52 ng/g

Macroalbuminuric type II diabetes

56 (27)

Composite outcome of risk of dialysis, or doubling of serum creatinine or deathb

30.7 (±10) months

OR 11.0 (1.6–76.4; p = 0.02)

0.65 (p = 0.08)/NR/NR

Fair (8)

Verhave et al [33]

Urine MCP-1 ≥ 48 ng/mmol

Diabetic nephropathy

83

The rate of eGFR decline as a continuous outcome

2.1 years

β coefficient

-2.0 ml/min/m2 (p = 0.001)

NR/NR/NR

Fair (7)

Ogliari et al [34]

Blood donor MCP-1 > 66th percentile

SPK recipients

77

Graft loss

87.4 (65.4–132.3) months

HR 4.5 (1.2–16.8; p = 0.02)

NR/NR/NR

Poor (6)

Nadkarni et al [35]

Urine MCP-1 (continuous and tertiles)

Type II diabetes

380 (50)

eGFR decline >40% from baseline

5 years

OR (continuous) 2.3 (1.4-3.6)

OR (3rd vs. 1st tertile) 5.3 (2.2-12.7)

C-statistic Conventional predictors: c 0.70

Addition of MCP-1: 0.74

Fair (7)

  1. AUC area under the curve, CAN chronic allograft nephropathy, eGFR estimated glomerular filtration rate, HC Healthy controls, HR Hazard ratio, MMP-2 matrix metalloprotinease-2, MCP-1 monocyte chemoattractant protein-1, NR not reported, OR odds ratio, PIINP procollagen type III amino-terminal pro- peptide, SPK simultaneous pancreas kidney transplant, TGF-β Transforming growth factor-beta
  2. *N represents the total sample size and the percentage represents the percent of those with the outcome when available in the literature
  3. aConventional Predictors: sex, body mass index, age, duration of diabetes mellitus, hemoglobin A1c, eGFR(CKD-EPI), randomized treatment interventions, urinary albumin/creatinine ratio, and history of macrovascular and microvascular events. bDeath only occurred in two people, hence the composite outcome was mainly worsening of renal function and study was included in phase II. c Sex, body mass index, hemoglobin A1C, eGFR, fibrate intervention, Angiotensin converting enzyme inhibitors/angiotensin II receptor blockers, urine albumin-creatinine ratio, and cardiovascular disease history
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BMC Nephrology

ISSN: 1471-2369

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