Urine Choline Oxidation Metabolites Predict Chronic Kidney Disease Progression in Patients With Type 2 Diabetes
Authors' conclusion
Urine choline and dimethylglycine independently predict the risk of CKD progression in individuals with type 2 diabetes. Dysregulation of intrarenal choline metabolism may be involved in tubulopathy leading to progressive loss of kidney function.
Study context
- Population
- Outpatients with T2D recruited from a secondary hospital and a primary care facility
- Participants
- 1,894 outpatients
- Exposure
- Urine choline oxidation metabolites and chronic kidney disease (CKD) progression
- Outcome
- CKD progression: composite of incident end-stage kidney disease (sustained eGFR <15 mL/min/1.73m2, maintenance dialysis, renal death) and doubling of serum creatinine
- Follow-up
- Median 9.2 years
Main finding
As reported in the abstract
CKD progression per 1 SD of urine metabolite
CKD progression events
263
Urine choline, aHR per 1 SD
1.32 [1.16-1.51] (95% CI)
Urine dimethylglycine, aHR per 1 SD
1.30 [1.14-1.47] (95% CI)
Observational data: associations, not effects.
Further findings
Correlation with tubulopathy biomarker dkk3
- Urine choline vs dkk3, Spearman rho
- 0.55
- Urine dimethylglycine vs dkk3, Spearman rho
- 0.53
Mutual adjustment with dkk3
- Association of dkk3 with CKD progression diminished; choline and dimethylglycine associations remained significant after mutual adjustments
All-cause death
- Urine choline, aHR
- 1.20 [1.06-1.37]
- Urine dimethylglycine, aHR
- 1.17 [1.04-1.33]
Original publication
Urine Choline Oxidation Metabolites Predict Chronic Kidney Disease Progression in Patients With Type 2 Diabetes. J Clin Endocrinol Metab. Published 13 May 2025. doi:10.
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