Observational studyBMC nephrology2025
Utility of trimethylamine N-oxide (TMAO) as a biomarker for risk stratification in chronic kidney disease: a multicenter observational study.
Observational study in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
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Who cites it
1 citing paper in PubMed.
- Trimethylamine N-oxide and Homocysteine in Kidney Function and Disease: Distinct Metabolic Origins, Shared Renal Determinants and Pathophysiological Pathways.International journal of molecular sciences · 2026Review
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundChronic kidney disease (CKD) is a significant global health challenge with a multifaceted etiology. Risk stratification and timely intervention are crucial for mitigating CKD progression. Trimethylamine N-oxide (TMAO), a gut microbiota metabolite, has been implicated in CKD pathogenesis. However, the lack of standardized diagnostic assays for TMAO has limited its clinical applicability.
methodsWe conducted a multicenter observational study in Southern China. Plasma TMAO levels were quantified using a newly developed liquid chromatography-mass spectrometry (LC-MS)-based diagnostic kit in a cohort of 272 participants, including healthy controls and CKD patients. We analyzed the correlation between TMAO levels and renal function indicators, evaluated the utility of TMAO for risk stratification in CKD, and assessed its independent association with reduced eGFR using multivariable logistic regression.
resultsPlasma TMAO levels were significantly elevated in CKD patients compared to healthy controls. TMAO levels increased with CKD severity and exhibited a strong positive correlation with serum creatinine (Scr) and a negative correlation with estimated glomerular filtration rate (eGFR). TMAO levels demonstrated excellent consistency with eGFR in both the full analysis set (FAS) and per protocol set (PPS) populations. Receiver operating characteristic (ROC) curve analysis indicated that TMAO could identify reduced eGFR with high accuracy (AUC: 0.916), which was confirmed by bootstrap validation. After adjusting for age, sex, hypertension, and diabetes, TMAO remained independently associated with reduced eGFR.
conclusionsOur findings suggest that TMAO is a promising and independent complementary biomarker for the risk stratification of CKD, though its prognostic value requires validation in longitudinal studies. The developed LC-MS kit enables robust clinical application. Further research is warranted to validate these findings in larger cohorts and explore TMAO's potential as a therapeutic target for CKD management.
trial registrationClinical Trails.gov identifier, ChiCTR2400089774 (retrospectively registered in 14/09/2024).
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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.