The following is a summary of “Metabolites Associated With Uremic Symptoms in Patients With CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study,” published in the January 2024 issue of Nephrology by Wulczyn et al.
In the cross-sectional study involving 1,761 participants from the Chronic Renal Insufficiency Cohort (CRIC) with chronic kidney disease (CKD) not on dialysis, researchers aimed to elucidate the unknown toxins contributing to uremic symptoms. Employing untargeted plasma metabolomic profiling and applying diverse statistical modeling approaches, including multivariable-adjusted linear regression, Lasso linear regression, and random forest models, they sought to identify solutes associated with uremic symptoms in CKD patients. Participants, with a mean estimated glomerular filtration rate (eGFR) of 43 mL/min/1.73 m2, exhibited diverse demographics, with 44% identifying as female and 41% as Non-Hispanic Black.
The prevalence of uremic symptoms, including fatigue, anorexia, pruritus, nausea, paresthesia, and pain, ranged from 22% to -55%. Their analysis revealed 17 metabolites positively associated with greater severity of at least one uremic symptom and 9 metabolites inversely linked to uremic symptom severity. Notably, many of these metabolites demonstrated at least a moderate correlation with eGFR, and some were associated with an elevated risk of developing kidney failure or mortality in multivariable-adjusted Cox regression models. Despite these valuable insights, their study is limited by the need for a second independent cohort for external validation of their findings.
In conclusion, their application of metabolomic profiling has successfully identified a spectrum of solutes associated with uremic symptoms in adults with CKD, underscoring the need for future validation and mechanistic studies to deepen their understanding of these associations.
Source: sciencedirect.com/science/article/pii/S0272638624000441
