• Nicolás R Robles, Juan Lopez Gomez, Guadalupe Garcia Pino, Julian Valladares, Roman Hernandez Gallego, and Isis Cerezo.
• Servicio de Nefrología, Hospital Universitario de Badajoz, Badajoz, España; Cátedra de Riesgo Cardiovascular, Facultad de Medicina, Universidad de Salamanca, Salamanca, España. Electronic address: nrrobles@yahoo.es.
• Med Clin (Barc). 2021 Oct 22; 157 (8): 368-370.

Objectivesα1-microglobulin (α1M) is a tubular protein used for detecting acute lesions of proximal tubules. This study evaluated the use of urine α1M excretion as a marker of chronic kidney disease (CKD) progression and life survival.Design And MethodsIn all 163 patients were recruited (90 men), mean age 61.6±16.4 years. Urinary α1M was evaluated using an immunonephelometric assay. Patients were divided into 2 groups according to urinary α1M excretion (cut-off value: 32.85mg/24h).ResultsEnd stage renal disease-free survival was 94.2% at 5 years for patients with lower α1M. For patients in the highest percentile, renal function survival was 72.7% (P=.011). Life survival was 94.4% for patients with α1M in the lower percentiles. For patients in the upper percentile, live survival was 54.2% (P=.001). The Cox regression analysis showed an independent association of CKD progression with high α1M excretion (P=.043).Conclusionsα1M urinary excretion was associated with faster CKD progression and higher mortality. Further studies are needed to determine whether the association between α1M urinary excretion and excess mortality risk represents a causal link.Copyright © 2020 Elsevier España, S.L.U. All rights reserved.

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