The urine-to-plasma urea concentration ratio is associated with eGFR and eGFR decline over time in a population cohort.

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State: Public
Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_CC6B42647AB8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The urine-to-plasma urea concentration ratio is associated with eGFR and eGFR decline over time in a population cohort.
Journal
Nephrology, dialysis, transplantation
Author(s)
Petrovic D., Bankir L., Ponte B., Pruijm M., Corre T., Ghobril J.P., Bouatou Y., Ackermann D., Vogt B., Bochud M.
ISSN
1460-2385 (Electronic)
ISSN-L
0931-0509
Publication state
Published
Issued date
2024
Peer-reviewed
Oui
Volume
39
Number
1
Pages
122-132
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Evaluation of renal function and of factors associated with its decline are important public health issues. Besides markers of glomerular function [e.g. glomerular filtration rate (GFR)], those of tubular functions are rarely evaluated. Urea, the most abundant urinary solute, is markedly concentrated in urine when compared with plasma. We explored the urine-to-plasma ratio of urea concentrations (U/P urea ratio) as a marker of tubular functions.
We evaluated the relationship of the U/P urea ratio with eGFR at baseline in 1043 participants (48 ± 17 years) from the Swiss Kidney Project on Genes in Hypertension (SKIPOGH) population-based cohort, using mixed regression. In 898 participants, we assessed the relation between U/P urea ratio and renal function decline between two study waves 3 years apart. We studied U/P ratios for osmolarity, Na, K and uric acid for comparison.
In a transversal study at baseline, estimated GFR (eGFR) was positively associated with U/P-urea ratio [βscaled = 0.08, 95% CI (0.04; 0.13)] but not with the U/P ratio of osmolarity. Considering separately participants with renal function >90 or ≤90 mL/min × 1.73 m2, this association was observed only in those with reduced renal function. In the longitudinal study, eGFR declined at a mean rate of 1.2 mL/min per year. A significant association was observed between baseline U/P urea ratio and eGFR decline [βscaled = 0.08, 95% CI (0.01; 0.15)]. A lower baseline U/P urea ratio was associated with a greater eGFR decline.
This study provides evidence that the U/P urea ratio is an early marker of kidney function decline in the general adult population. Urea is easy to measure with well-standardized techniques and at low cost. Thus, the U/P urea ratio could become an easily available tubular marker for evaluating renal function decline.
Keywords
Adult, Humans, Longitudinal Studies, Urea, Kidney, Glomerular Filtration Rate, Kidney Function Tests, Renal Insufficiency, Chronic/epidemiology, Risk Factors, chronic kidney disease, potassium, tubular marker, uric acid, urine concentration
Pubmed
Open Access
Yes
Create date
03/07/2023 15:36
Last modification date
22/02/2024 7:15
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