ESPN 54th Annual Meeting

ESPN 2022


 
Urine DKK3 and Chronic Kidney Disease Progression in Children with CAKUT, Is It a Reliable Biomarker?
AYŞE SEDA PINARBAŞI 1 NESLİHAN GÜNAY 2 İNAYET GÜNTÜRK 3 DİDEM BARLAK KETİ 4 SİBEL YEL 6 SEKURE RABİA ULUEREN 5 CEVAT YAZICI 4 MUAMMER HAKAN POYRAZOĞLU 6 İSMAİL DURSUN 6

1- DIYARBAKIR CHILDREN HOSPITAL, PEDIATRIC NEPHROLOGY
2- KAYSERI STATE HOSPITAL, PEDIATRIC NEPHROLOGY
3- NIĞDE ÖMER HALISDEMIR UNIVERSITY, FACULTY OF MEDICINE, DEPARTMENT OF BIOCHEMISTRY
4- ERCIYES UNIVERSITY, FACULTY OF MEDICINE, DEPARTMENT OF BIOCHEMISTRY
5- ERCIYES UNIVERSITY, FACULTY OF MEDICINE
6- ERCIYES UNIVERSITY, FACULTY OF MEDICINE, DEPARTMENT OF PEDIATRIC NEPHROLOGY
 
Introduction:

Chronic kidney disease (CKD) is an important public health issue. Although serum creatinine is most commonly used marker to estimate glomerular filtration rate (GFR), it is affected by many variables such as muscle mass, the search continues for different biomarkers. Recently, DKK3 levels secreted into the urine has been emerged to use as a short-term, non-invasive biomarker of evaluation of CKD progression. This study was conducted to determine the role of urine DKK3 levels in predicting CKD stage and progression in children with congenital abnormalities of the kidney and urinary tract (CAKUT).

Material and methods:

CKD Stage 1-4 patients followed up with CAKUT were included into the study. Urine DKK3 levels, eGFR and urine albumin to creatinine ratio were measured at baseline and at least 6 months of follow-up in children with CAKUT. These values were compared between the CKD groups and with the control group.

Results:

A total of 113 patients with CKD stage 1-4 and 28 healthy controls were included into the study. Baseline urine DKK3/creatinine ratio was negatively correlated with eGFR and positively correlated with urine albumin creatinine ratio. When the patients were re-evaluated 6 months later, no correlation was found between urine DKK3 and eGFR changes. Only baseline eGFR was found to be independent predictor for increased urine DKK3 to creatinine ratio in multivariate regression. At the cutoff of 1675,48 pg/mg with 71.1% sensitivity and 71.4% specify.

Conclusions:

Urine DKK3 is thought to be an important marker for the progression of CKD as an indicator of renal fibrosis. In this study, we showed high level of urinary DKK3 especially in patients with stage 3-4 CKD in the CAKUT group, which is one of the most important causes of CKD in children, but it is insufficient to predict worsening of eGFR in short-term follow-up of children with CAKUT.