Effect of corrections for renal function on plasma phosphorylated tau performance for Alzheimer's disease.

IF 3.4 3区 医学 Q2 NEUROSCIENCES
Kenichiro Sato, Yoshiki Niimi, Ryoko Ihara, Atsushi Iwata, Kazushi Suzuki, Takeshi Iwatsubo
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引用次数: 0

Abstract

BackgroundBlood-based biomarkers (BBMs), including plasma phosphorylated tau (pTau), have been considered as a promising, less-invasive tool for detecting Alzheimer's disease (AD) pathology in real-world applications. Plasma pTau levels are known to be elevated in individuals with chronic kidney disease, which may require caution when corrected for renal function since it alters testing performance-decreased sensitivity and increased specificity.ObjectiveWe aimed to quantify how correcting for renal function affects BBM test performance.MethodsWe analyzed plasma pTau181 and pTau217 measured by multiple platforms, using data from our ongoing trial-ready cohort study in Japan and the ADNI study, in which approximately 30% of participants had mild or moderate renal impairment (eGFR < 60). We compared models with and without renal correction to predict amyloid PET positivity status.ResultsCompared to no correction, adjusting for renal function reduced sensitivity by 0.06-0.07 and increased specificity by 0.04-0.10. It also slightly increased positive predictive value, negative predictive value, balanced accuracy, and area under the curve-each by less than 0.02. These shifts by correction were more pronounced when the participant prevalence of those with renal function was higher, though mainly for sensitivity and specificity.ConclusionsOur findings demonstrated that applying renal function correction decreases sensitivity and increases specificity of BBM test depending on the prevalence of renal impairment, without undermining overall prediction accuracy. They emphasize the need of considering the background characteristics of the target population when interpreting BBM performances in the real-world settings.

纠正肾功能对阿尔茨海默病血浆磷酸化tau表现的影响。
基于血液的生物标志物(BBMs),包括血浆磷酸化tau (pTau),被认为是一种有前途的,在现实应用中检测阿尔茨海默病(AD)病理的微创工具。已知慢性肾脏疾病患者血浆pTau水平升高,在校正肾功能时可能需要谨慎,因为它会改变检测性能-降低敏感性和增加特异性。目的量化肾功能矫正对BBM测试结果的影响。方法:我们分析了多种平台测量的血浆pTau181和pTau217,使用了我们正在进行的日本试验队列研究和ADNI研究的数据,其中大约30%的参与者患有轻度或中度肾损害(eGFR)
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来源期刊
Journal of Alzheimer's Disease
Journal of Alzheimer's Disease 医学-神经科学
CiteScore
6.40
自引率
7.50%
发文量
1327
审稿时长
2 months
期刊介绍: The Journal of Alzheimer''s Disease (JAD) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer''s disease. The journal publishes research reports, reviews, short communications, hypotheses, ethics reviews, book reviews, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research that will expedite our fundamental understanding of Alzheimer''s disease.
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