Evidence map›Paper›PMID 28029431›Full record

ArticleKidney international2017

Urine biomarkers of tubular injury do not improve on the clinical model predicting chronic kidney disease progression.

Chi-Yuan Hsu, Dawei Xie, Sushrut S Waikar, Joseph V Bonventre, Xiaoming Zhang, Venkata Sabbisetti, Theodore E Mifflin, Josef Coresh, Clarissa J Diamantidis, Jiang He and 13 more

Open access · bronzeAbstract readValidation Study
In one paragraph

Article in Kidney international, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 3 pooled it
7.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 3 syntheses or guidelines pooled it, 109 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Towards the best kidney failure prediction tool: a systematic review and selection aid.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2020
    Pooled it
  4. Dietary sodium restriction decreases urinary NGAL in older adults with moderately elevated systolic blood pressure free from chronic kidney disease.Journal of investigative medicine : the official publication of the American Federation for Clinical Research · 2020
    Trial
  5. Effect of Intensive Blood Pressure Lowering on Kidney Tubule Injury: Findings From the ACCORD Trial Study Participants.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2019
    Trial
  6. Dickkopf-3 (DKK3) in Urine Identifies Patients with Short-Term Risk of eGFR Loss.Journal of the American Society of Nephrology : JASN · 2018
    Trial
  7. Article
  8. Article
  9. Review
  10. Article
  11. Review
  12. Authors' Reply: Novel Biomarkers in CKD.Journal of the American Society of Nephrology : JASN · 2026
    Article
  13. Biomarkers of Kidney Failure and All-Cause Mortality in CKD.Journal of the American Society of Nephrology : JASN · 2025
    Article
  14. Article
  15. Article
  16. Review
  17. Review
  18. Review
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors at 13 institutions in 1 country.

Chi-Yuan HsuUniversity of California, San Francisco, San Francisco, California, USA; Kaiser Permanente Northern California, Oakland, California, USA. Electronic address: hsuchi@medicine.ucsf.edu.
Dawei XieUniversity of Pennsylvania, Philadelphia, Pennsylvania, USA.
Sushrut S WaikarBrigham and Women's Hospital, Boston, Massachusetts, USA.
Joseph V BonventreBrigham and Women's Hospital, Boston, Massachusetts, USA.
Xiaoming ZhangUniversity of Pennsylvania, Philadelphia, Pennsylvania, USA.
Venkata SabbisettiBrigham and Women's Hospital, Boston, Massachusetts, USA.
Theodore E MifflinUniversity of Pennsylvania, Philadelphia, Pennsylvania, USA.
Josef CoreshJohns Hopkins University, Baltimore, Maryland, USA.
Clarissa J DiamantidisDuke University, Durham, North Carolina, USA.
Jiang HeTulane University, New Orleans, Louisiana, USA.
Claudia M LoraUniversity of Illinois, Chicago, Illinois, USA.
Edgar R MillerJohns Hopkins University, Baltimore, Maryland, USA.
Robert G NelsonNational Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA.
Akinlolu O OjoUniversity of Michigan, Ann Arbor, Michigan, USA.
Mahboob RahmanCase Western Reserve University, Cleveland, Ohio, USA.
Jeffrey R SchellingCase Western Reserve University, Cleveland, Ohio, USA.
Francis P WilsonYale University, New Haven, Connecticut, USA.
Paul L KimmelNational Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA.
Harold I FeldmanUniversity of Pennsylvania, Philadelphia, Pennsylvania, USA.
Ramachandran S VasanBoston University, Boston, Massachusetts, USA.
Kathleen D LiuUniversity of California, San Francisco, San Francisco, California, USA.
CRIC Study Investigators
CKD Biomarkers Consortium
University of Pennsylvania · USBrigham and Women's Hospital · USCase Western Reserve University · USJohns Hopkins University · USNational Institute of Diabetes and Digestive and Kidney Diseases · USTulane University · USUniversity of Michigan · USBoston University · USDuke University · USKaiser Permanente · USUniversity of California, San Francisco · USUniversity of Illinois Chicago · USYale University · US

Funding

UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
Scientific and Data Coordinating Center(SDCC) for the P*U01DK060990 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI FELDMAN, HAROLD I · 2001 to 2017
$50.1M
Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
Michigan Institute for Clinical and Health Research (MCHR)UL1TR000433 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MASHOUR, GEORGE ALEXANDER · 2012 to 2016
$49.9M
Institutional Clinical and Translational Science AwardUL1TR000003 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2012 to 2015
$38.9M
Zonulin Antibodies in Intestinal Permeabilitiy in IDDMM01RR016500 · NCRR · UNIVERSITY OF MARYLAND BALTIMORE · PI WATSON, DOUGLAS · 2002 to 2009
$20.2M
Study of the Care and Outcomes of REnal InsufficiencyU01DK060902 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI GO, ALAN S · 2001 to 2025
$19.5M
Limited Competition for the Continuation of the Chronic Renal Insufficiency CohorU01DK061021 · NIDDK · CASE WESTERN RESERVE UNIVERSITY · PI RAHMAN, MAHBOOB · 2001 to 2025
$17.3M
Prospective Renal Insufficiency Cohort Evaluation:PRICEU01DK060984 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI COHEN, DEBBIE L · 2001 to 2025
$17.0M
Prospective Cohort Study of Chronic Renal InsufficiencyU01DK061028 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI RAO, PANDURANGA S · 2001 to 2025
$16.9M
Limited Competition for the Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Hopkins Clinical CenterU01DK061022 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI APPEL, LAWRENCE JOHN · 2001 to 2025
$15.7M
Proposal for a Chicago-CRIC Clinical CenterU01DK060980 · NIDDK · UNIVERSITY OF ILLINOIS AT CHICAGO · PI LASH, JAMES P. · 2001 to 2025
$15.4M
NCATS NIH HHS UL1 TR000003NCATS NIH HHS UL1 TR000424NCATS NIH HHS UL1 TR000433NCATS NIH HHS UL1 TR000439NCRR NIH HHS M01 RR016500NCRR NIH HHS UL1 RR024131NCRR NIH HHS UL1 RR029879NIDDK NIH HHS K23 DK097201NIDDK NIH HHS R01 DK072381NIDDK NIH HHS R01 DK139225NIDDK NIH HHS U01 DK060902NIDDK NIH HHS U01 DK060963NIDDK NIH HHS U01 DK060980NIDDK NIH HHS U01 DK060984NIDDK NIH HHS U01 DK060990NIDDK NIH HHS U01 DK061021NIDDK NIH HHS U01 DK061022NIDDK NIH HHS U01 DK061028NIDDK NIH HHS U01 DK085649NIDDK NIH HHS U01 DK085651NIDDK NIH HHS U01 DK085660NIDDK NIH HHS U01 DK085673NIDDK NIH HHS U01 DK085688NIDDK NIH HHS U01 DK085689NIDDK NIH HHS U01 DK104308NIGMS NIH HHS P30 GM103337
6 · The paper itself

Abstract

Few investigations have evaluated the incremental usefulness of tubular injury biomarkers for improved prediction of chronic kidney disease (CKD) progression. As such, we measured urinary kidney injury molecule-1, neutrophil gelatinase-associated lipocalin, N-acetyl-ß-D-glucosaminidase and liver fatty acid binding protein under highly standardized conditions among 2466 enrollees of the prospective Chronic Renal Insufficiency Cohort Study. During 9433 person-years of follow-up, there were 581 cases of CKD progression defined as incident end-stage renal disease or halving of the estimated glomerular filtration rate. Levels of the urine injury biomarkers, normalized for urine creatinine, were strongly associated with CKD progression in unadjusted Cox proportional hazard models with hazard ratios in the range of 7 to 15 comparing the highest with the lowest quintiles. However, after controlling for the serum creatinine-based estimated glomerular filtration rate and urinary albumin/creatinine ratio, none of the normalized biomarkers was independently associated with CKD progression. None of the biomarkers improved on the high (0.89) C-statistic for the base clinical model. Thus, among patients with CKD, risk prediction with a clinical model that includes the serum creatinine-based estimated glomerular filtration rate and the urinary albumin/creatinine ratio is not improved on with the addition of renal tubular injury biomarkers.

Indexed as

AcetylglucosaminidaseAgedAlbuminuriaBiomarkersCreatinineDisease ProgressionFatty Acid-Binding ProteinsFemaleFollow-Up StudiesGlomerular Filtration RateHepatitis A Virus Cellular Receptor 1HumansKidney Failure, ChronicKidney TubulesLipocalin-2MaleAcetylglucosaminidaseBiomarkersCreatinineFABP1 protein, humanFatty Acid-Binding ProteinsHAVCR1 protein, humanHepatitis A Virus Cellular Receptor 1LCN2 protein, humanLipocalin-2chronic kidney diseasemicroalbuminuriaproteinuria

Identifiers

PMID28029431
PMCPMC5362331
OpenAlexW2545234811

What Socratic holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.