Raghavan PADMANABHAN, Kaviya MANOHARAN, Melina SAHAY, Pooja BHUJANGARAO, Luxitaa GOENKA, Solai PRIYA, Kumarasamy SUBRAMANIYAN, Damal Kandadai SRIRAM, Melvin GEORGE
Turkish Journal of Medical Sciences - 2026;56(2):454-463
Background/aim: Several biomarkers have been assessed for the diagnosis of chronic kidney disease (CKD). However, limited data are available regarding their ability to predict mortality in CKD. The aim of this study was to assess the ability of lipocalin-2, receptor for advanced glycation end products (RAGE), tissue inhibitor of metalloproteinase 1 (TIMP-1), osteopontin, and trefoil factor 3 (TFF-3) in predicting the prognosis of patients with CKD. Materials and methods: We included patients with CKD as defined by an estimated glomerular filtration rate of <60 mL/min/1.73 m2 of either sex who were above the age of 18 years. Patients with a history of acute-on-chronic kidney disease were excluded. The novel markers of interest were estimated from patients' plasma samples using the multiplex enzyme-linked immunosorbent assay. These patients were followed for 1 year to assess mortality. Results: The median (with interquartile range) plasma concentrations of lipocalin-2, RAGE, TIMP-1, osteopontin, and TFF-3 were 56.9 (44.72-64.18) ng/mL, 7.1 (4.92-9.56) ng/mL, 46.44 (33.52-47.56) ng/mL, 60.2 (98.9-167.61) ng/mL, and 4.87 (8.03-15.65) ng/mL, respectively. A combined receiver operating characteristic curve was plotted to determine the ability of the novel renal biomarkers to predict mortality in patients with CKD. The cutoff values for lipocalin-2 and RAGE for predicting mortality were 62.48 ng/mL with sensitivity and specificity of 86% and 78% (area under the curve: 0.814; p = 0.007) and 8.5 ng/mL with sensitivity and specificity of 71% and 72% (area under the curve: 0.738; p = 0.04), respectively. Conclusion: Biomarkers including lipocalin-2 and RAGE were assessed in this study and were found to have good predictive value for mortality outcomes in CKD. Future studies should establish the relationship between these novel renal biomarkers and the progression of CKD.
