Sensitive and useful biomarkers for predicting chronic kidney disease (CKD) and its prognosis are urgently needed. Using a nontargeted metabolomic approach, Hu et al. explored an established CKD cohort, Modification of Diet in Renal Disease, as well as a validation cohort, African American Study of Kidney Disease and Hypertension. They identified 3 serum metabolites (ribonate, fumarate, and allantoin) significantly associated with mortality in CKD even after statistical adjustment by multiple clinical covariates including glomerular filtration rate and urinary protein. Their finding develops a new aspect for diagnosing and predicting the prognosis of CKD.
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