Metabolomic profiling to improve glomerular filtration rate estimation: a proof-of-concept study

Abstract

Multimetabolite panels can enable accurate GFR estimation. Metabolomic equations, preferably excluding creatinine and demographic characteristics, should be tested for robustness and generalizability as a potential confirmatory test when eGFRcr is unreliable.

GFR Estimation Using a Panel of Filtration Markers in Shanghai and Beijing

“…eGFR B2M and eGFR BTP were not more accurate than eGFR cr and eGFR cys , consistent with the hypothesis that the improved accuracy of eGFR avg over eGFR cr-cys is not due to greater contribution to GFR estimation of B2M and BTP than creatinine or cystatin C, but reflects lesser contribution of non-GFR determinants of each filtration marker as more markers are added to the panel. These findings support the growing literature that GFR estimation can be improved by the use of a panel of filtration markers, even if they are not more strongly associated with mGFR than creatinine and cystatin C. 29,30 However, in this study, the improvement in accuracy did not generally translate into statistically significant improvement in classification or reclassification of mGFR categories by eGFR avg compared with eGFR cr or eGFR cr-cys , and we would not recommend use of B2M or BTP in GFR estimating equations in clinical practice at this time.…”

How to assess kidney function in oncology patients

“…To date, few GFR estimating equations have met the National Kidney Foundation Kidney Disease Outcomes Quality Initiative 2002 aspirational target of P 30 > 90%. 18,19 However, a recent development of a panel of endogenous filtration markers carries the promise circumventing the variation in non-GFR determinants hitherto, limiting the accuracy of GFR estimation 20 (Table 1 [16][17][18] ).…”

Potential for Novel Biomarkers in Diabetes-Associated Chronic Kidney Disease: Epigenome, Metabolome, and Gut Microbiome

“…One of the most salient confounders in metabolomic studies of chronic kidney disease is kidney function itself [ 49 ]. Kidney function, assessed as the glomerular filtration rate (GFR), is related to about one third of the detected metabolites in both general and CKD populations [ 50 ]. Illustrating the importance of the consideration of baseline GFR, Grams et al showed a marked attenuation in the number of statistically significant metabolite associations when adjusted for baseline kidney function [ 49 ].…”