Bullen AL, Fregoso-Leyva A, Katz R, Long DL, Cheung KL, Judd SE, Gutierrez OM, Ix JH, Cushman M, Rifkin DE. Proneurotensin/Neuromedin N and Risk of Incident CKD and Other Kidney Outcomes in Community-Living Individuals: The REGARDS Study.
Kidney Med 2024;
6:100831. [PMID:
38774125 PMCID:
PMC11107458 DOI:
10.1016/j.xkme.2024.100831]
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Abstract
Rationale & Objective
Plasma proneurotensin/neuromedin N (pro-NT/NMN) is a precursor of neurotensin, a tridecapeptide linked with type 2 diabetes mellitus and other comorbid conditions associated with kidney disease. Whether pro-NT/NMN is directly associated with incident chronic kidney disease (CKD), and whether that association differs by race, is uncertain. We evaluated whether pro-NT/NMN levels were associated with increased risk of kidney outcomes.
Study Design
Prospective cohort.
Setting & Participants
Participants in Biomarker Mediators of Racial Disparities in Risk Factors, a nested cohort from the REasons for Geographic And Racial Differences in Stroke study, with available stored serum and urine samples from baseline and second visits for biomarker measurement.
Exposure
Baseline log-transformed pro-NT/NMN.
Outcomes
Incident CKD, progressive estimated glomerular filtration rate (eGFR) decline, incident albuminuria, and incident kidney failure within median follow-up time of 9.4 years.
Analytical Approach
Logistic regression.
Results
Among 3,914 participants, the mean ± SD age was 64 ± 8 (SD) years, 48% were women, and 51% were Black. Median baseline eGFR was 90 (IQR, 77-102) mL/min/1.73 m2. Each SD higher of pro-NT/NMN was associated with 9% higher odds of progressive eGFR decline (OR, 1.09; 95% CI, 1.00-1.20). There was no association observed with incident CKD (OR, 1.10; 95% CI, 0.96-1.27), incident albuminuria (OR, 1.08; 95% CI, 0.96-1.22), or incident kidney failure (OR, 1.10; 95% CI, 0.83-1.46). There were no differences in results by race or sex.
Limitations
Single measurement of pro-NT/NMN and limited generalizability.
Conclusions
Higher pro-NT/NMN was associated with progressive eGFR decline but no other manifestations of kidney disease incidence.
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