Urine albumin-creatinine ratio as a predictor of kidney function decline in alport syndrome

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ID: 317079
2026
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Abstract
Abstract Background Chronic kidney disease (CKD) significantly impacts health and lifespan, but its progression remains difficult to predict. Therefore, there is a need for biomarkers to identify patients at risk of a rapid decline in kidney function. Alport syndrome (AS) exemplifies this challenge, as some patients experience rapid progression, others exhibit a more gradual decline in kidney function. We hypothesized that urinary proteins, such as albumin, Immunoglobulin G (IgG) or alpha-1-microglobulin could serve as predictors of kidney function decline. Methods This observational, non-interventional, retrospective study investigated 127 patients with AS from two centres. Yearly eGFR loss was modelled in a linear regression model. Results Over a 42 ± 26-month follow-up, 24% of the patients had rapid eGFR decline (defined as a loss of more than 6 mL/min/1.73m2 per year). UACR showed the highest negative correlation with the change in eGFR (ρ=-0.435, P < 0.001; n = 109). After adjusting for age, gender, RASi, mode of inheritance, and eGFR, UACR was independently associated with the yearly eGFR loss (P < 0.001). Urinary IgG had the highest sensitivity in identifying patients with kidney function decline. Conclusion In this study, the amount of albuminuria was independently associated with the yearly loss of kidney function in patients with AS. Combined measurement of albuminuria and urinary IgG may identify patients with the highest risk of rapid decline in kidney function. Following external validation in a larger, prospective cohort, this approach could be used to identify patients who could potentially benefit from closer monitoring and earlier intervention.
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Authors Jan Halbritter, Mira Choi, Annika Jens, Sima Jami, Andreas Leha, Yanqin Zhang, Jan Halbritter, Oliver Groß
Journal clinical kidney journal
Year 2026
DOI
10.1093/ckj/sfag191
URL
https://doi.org/10.1093/ckj/sfag191
Keywords Keywords not found

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