Proenkephalin A 119-159 (penKid) and mortality in stable patients at high cardiovascular risk

Matthias Rau, Berkan Kurt, Oliver Hartmann, Fábia Daniela Lobo de Sá, Marvin Schwarz, Kirsten Thiele, Niels-Ulrik Korbinian Hartmann, Jens Spiesshoefer, Julia Möllmann, Mathias Hohl, Simina-Ramona Selejan, Emiel P C van der Vorst, Edgar Dahl, Nikolaus Marx, Florian Kahles, Michael Lehrke

Research output: Contribution to journalOriginal Articlepeer-review

Abstract

BACKGROUND: Proenkephalin A 119-159 (penKid) is a novel blood biomarker for real-time assessment of kidney function and was found to be independently associated with worsening kidney function and mortality. A novel penKid-based estimated glomerular filtration rate equation (eGFRPENK-Crea), outperforms current creatinine-based eGFR equations in predicting iohexol or iothalamate plasma clearance-based measured GFR. In this study, we aimed to evaluate the predictive value of penKid and eGFRPENK-Crea for all-cause mortality in stable patients at high cardiovascular risk.

METHODS: Circulating penKid levels were assessed in 615 stable patients hospitalized at the Department of Cardiology at University Hospital Aachen, Germany. The endpoint was all-cause mortality; follow up was 3 years.

RESULTS: penKid levels were higher in 46 non-survivors [58.8 (IQR 47.5-85.0) pmol/l] compared to 569 survivors [43.8 (IQR 34.0-58.0) pmol/l; P < .0001]. Univariable Cox regression analyses found penKid and eGFRPENK-Crea to be associated with all-cause mortality (C index 0.703, χ 2 33.27, P < .00001; C index 0.716, χ 2 36.51, P < .00001). This association remained significant after adjustment for significant baseline parameters including age, smoking, chronic heart failure, use of diuretics, leucocytes, body mass index, sex, and creatinine (C index 0.799, χ 2 72.06, P < .00001). Importantly, penKid provided significant added value on top of eGFRCKD-EPI 2021 (eGFRCKD-EPI 2021: C index 0.716, χ 2 34.21; eGFRCKD-EPI 2021 + penKid: C index 0.727, χ 2: 40.02; Delta χ 2 5.81; all P < .00001) for all-cause mortality prediction in our cohort.

CONCLUSIONS: penKid levels and eGFRPENK-Crea is associated with all-cause mortality within a 3-year follow-up period and the addition of penKid on top of eGFRCKD-EPI 2021 provided significant added value in mortality prediction.

Original languageEnglish
Pages (from-to)fae246
JournalCLINICAL KIDNEY JOURNAL
Volume17
Issue number9
DOIs
Publication statusPublished - Sept 2024

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