#4948 ROLE OF REGENERATING PROTEIN 1A IN THE PROGRESSION OF CHRONIC KIDNEY DISEASE

Abstract

Abstract Background and Aims Regenerating protein 1a (Reg 1a) is a secretory protein mostly produced by the pancreas. Serum levels of Reg 1a has been found increased in patients with diabetic nephropathy, which may be a potential indicator of renal dysfunction. Here, we investigated whether Reg 1a was associated with renal function in chronic kidney disease (CKD) and further to evaluate its predictive value of progress in renal dysfunction. Method Serum Reg 1a levels were measured by a double antibody sandwich ELISA enzyme-linked immunosorbent assay. Demographics information and clinical biochemical parameters such as blood urea nitrogen (BUN), serum creatinine (Scr), uric acid (UA) and urinary albumin-to-creatinine ratio (UACR) were collected. Correlations between serum Reg 1a and other factors were presented by Spearman's correlation coefficient and partial correlation analysis. Multivariate logistic regression analysis was utilized to identify the independent risk factors for chronic renal dysfunction and the progress in CKD. Draw the receiver operating characteristic curve (ROC curve) and calculate the area under the curve (AUC) to analyze the effectiveness of the individual serum Reg 1a. Statistical analyses were conducted using SPSS 20.0 software, Med-Calc statistical software. Results A total of 640 participants were enrolled in this study including non-CKD subjects (n = 240) and patients with CKD (n = 400). Compared with non-CKD group, participants in CKD group had higher level of serum reg 1a (188.2 [66.7∼387.6] ng/ml vs 23.8 [14.7∼35.1] ng/ml, P<0.001). Serum reg 1a level elevated with increasing grades of CKD. Serum reg 1a was negatively correlated with eGFR and positively associated with age, hypertension, Scr, BUN, UA and UACR (P<0.001). In multiple logistic regression analysis, serum reg 1a was one of independent risk factors to predict renal dysfunction (OR = 1.010 [1.003, 1.018], P = 0.008). The AUC for serum reg 1a to predict CKD was 0.889 [0.862, 0.913], and the AUC for serum reg 1a to screen the eGFR lower than 30 ml/min/1.73 m2 in CKD groups was 0.919 [0.888, 0.944]. Subgroup analysis showed that serum reg 1a is an independent risk factor to predict early progress of UACR (OR = 1.012 [1.002, 1.022], P = 0.016) in CKD patients. Conclusion The study provides clinical evidence that serum reg 1a may a meaningful biomarker of early kidney impairment and a useful supplementary factor in the progression of CKD.