Pro-Neurotensin/Neuromedin N and Risk of Incident Chronic Kidney Disease and Other Kidney Outcomes in Community-Living Individuals: The REGARDS Study

Rationale & Objective Plasma pro-neurotensin/neuromedin (pro-NT/NMN) is a precursor of neurotensin, a tridecapeptide linked with type 2 diabetes mellitus and other comorbidities associated with kidney disease. Whether pro-NT/NMN is directly associated with incident chronic kidney disease (CKD), and whether that association differs by race, is uncertain. We evaluated whether pro-NT/NMN levels were associated with increased risk of kidney outcomes. Study Design Prospective Setting & Participants Participants in BioMedioR (Biomarker Mediators of Racial Disparities in Risk Factors) a nested cohort from REGARDS (REasons for Geographic And Racial Differences in Stroke) with available stored serum and urine samples from baseline and second visits for biomarker measurement. Exposure Baseline log-transformed pro-NT/ Outcomes Incident CKD, progressive eGFR decline, incident albuminuria, and incident kidney failure within median follow-up time of 9.4 years. Analytical Approach Logistic regression Results Among 3914 participants the mean (SD) age was 64 (8) years, 48% were women, and 51% were Black. Median baseline eGFR was 90 (interquartile range [IQR] 77, 102) mL/min/1.73m2. Each SD higher of pro-NT/NMN was associated with 9% higher odds of progressive eGFR decline (OR: 1.09; 95% CI 1.00, 1.20). There was no association observed with incident CKD (OR 1.10: 95% CI 0.96, 1.27), incident albuminuria (OR:1.08; 0.96, 1.22) or incident kidney failure (OR: 1.10; 95% CI 0.83, 1.46). There were no differences in results by race or sex. Limitations Single measurement of pro-NT/NMN and limited generalizability. Conclusions Higher pro-NT/NMN was associated with progressive eGFR decline but no other manifestations of kidney disease incidence.