image: Visual Abstract: Strong associations for CXCL12, urine NGAL, and cardiac markers may even exceed that of systolic BP ?140 mmHg, a well-established risk factor for CKD progression.
The primary goal of this study by Amanda H. Anderson et al was to identify independent risk factors of CKD progression among participants with and without diabetes in a prospective CKD cohort study (N=3,379). Among those with diabetes, CKD progression rates approximately doubled with higher levels of the inflammatory chemokine CXCL12, the cardiac marker NTproBNP and the kidney injury marker urine NGAL. Among those without diabetes, rates increased over 1.5-fold with higher levels of high-sensitivity troponin T, NTproBNP, and urine NGAL. The strength of these associations exceeded that of systolic blood pressure ≥140 mmHg, a well-established risk factor for kidney disease progression. These findings provide insights into potential mechanisms of CKD progression and will guide future research in defining subgroups at highest risk for CKD progression.