Renal failure · 2026
Urinary NGAL and trehalase predict end-stage kidney disease in ANCA-associated vasculitis: a prospective cohort study.
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Qiu Miaohua, Guan Mengqian, Weng Xiaoxue, Zheng Ruiying, Chen Jiejian, Peng Weihua
Аннотация
BACKGROUND: Accurate prediction of renal outcomes in ANCA-associated vasculitis (AAV) is critical. This study evaluated the predictive value of urinary biomarkers for end-stage kidney disease (ESKD) progression.
METHODS: A prospective cohort of 88 AAV patients with renal involvement was followed for a median of 27 months. Urinary β-catenin, IL-18, trehalase, and NGAL were measured. Cox regression and ROC analyses assessed associations and predictive performance.
RESULTS: 65 patients (73.9%) progressed to ESKD. Urinary trehalase and NGAL were significantly elevated in the ESKD group and were independent predictors of ESKD in multivariable analysis (both p < 0.05), with AUCs of 0.857 and 0.852, respectively. Their combination improved predictive accuracy (AUC = 0.869). β-catenin showed moderate predictive value (AUC = 0.705). Although urinary IL-18 showed statistical significance when analyzed as a continuous variable in an initial model, this association was not consistent across alternative modeling strategies and therefore was not considered a stable independent predictor. Stratified and landmark analyses confirmed the robustness of trehalase and NGAL's prognostic value.
CONCLUSION: Urinary trehalase and NGAL are strong, noninvasive predictors of ESKD in AAV, and their combination enhances risk stratification, supporting potential clinical utility for personalized treatment decisions.
METHODS: A prospective cohort of 88 AAV patients with renal involvement was followed for a median of 27 months. Urinary β-catenin, IL-18, trehalase, and NGAL were measured. Cox regression and ROC analyses assessed associations and predictive performance.
RESULTS: 65 patients (73.9%) progressed to ESKD. Urinary trehalase and NGAL were significantly elevated in the ESKD group and were independent predictors of ESKD in multivariable analysis (both p < 0.05), with AUCs of 0.857 and 0.852, respectively. Their combination improved predictive accuracy (AUC = 0.869). β-catenin showed moderate predictive value (AUC = 0.705). Although urinary IL-18 showed statistical significance when analyzed as a continuous variable in an initial model, this association was not consistent across alternative modeling strategies and therefore was not considered a stable independent predictor. Stratified and landmark analyses confirmed the robustness of trehalase and NGAL's prognostic value.
CONCLUSION: Urinary trehalase and NGAL are strong, noninvasive predictors of ESKD in AAV, and their combination enhances risk stratification, supporting potential clinical utility for personalized treatment decisions.