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Complement contributes to kidney injury, a condition often occurring in patients with alcohol\u2010associated liver disease (ALD). However, little is known regarding complement in cross talk between liver and kidney in ALD. Here, we tested the hypothesis that urinary complement would provide potential biomarkers for ALD and insights into mechanisms of liver\u2013kidney cross talk in the pathogenesis of ALD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Plasma and urine were collected at admission from patients with severe alcoholic hepatitis (sAH), healthy controls (HC), and heavy drinkers without liver disease (HD) (from the multicenter Alcohol Hepatitis Network) and with AC (from the Northern Ohio Alcohol Center). Urine was subjected to unbiased proteomics analysis and plasma complement assessed by multiplex\/ELISA assays. Thirty\u2010 and 90\u2010day mortality was tracked in patients with sAH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All three complement activation pathways were perturbed in plasma and urine of patients with sAH and AC compared to HC and HD. Components of the lectin and classical pathways in urine were associated with 30\u2010 and 90\u2010day mortality in patients with sAH. When four complement proteins were combined, they distinguished sAH from AC (AUC 0.78), equivalent to that of model for end\u2010stage liver disease (MELD) (AUC 0.65). There was no correlation between complement in plasma and urine, suggesting an independent impact of sAH on complement in kidney and liver.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The urinary proteome revealed complement protein signatures associated with sAH and AC, providing valuable insights into the potential for complement biomarkers and the mechanisms of liver\u2013kidney cross talk in ALD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70353","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:23:14Z","timestamp":1782454994000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Urine Proteomic Profiling at Admission Reveals Complement Biomarkers Linked to Alcohol\u2010Associated Liver Disease"],"prefix":"10.1111","volume":"50","author":[{"given":"Luan","family":"Prado","sequence":"first","affiliation":[{"name":"Department of Inflammation and Immunity Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Musich","sequence":"additional","affiliation":[{"name":"Department of Inflammation and Immunity Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moyinoluwa","family":"Taiwo","sequence":"additional","affiliation":[{"name":"Department of Inflammation and Immunity Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vai","family":"Pathak","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Rotroff","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic  Cleveland Ohio USA"},{"name":"Endocrine and Metabolism Institute Cleveland Clinic  Cleveland Ohio USA"},{"name":"Center for Quantitative Metabolic Research Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Bellar","sequence":"additional","affiliation":[{"name":"Department of Inflammation and Immunity Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Welch","sequence":"additional","affiliation":[{"name":"Department of Inflammation and Immunity Cleveland Clinic  Cleveland Ohio USA"},{"name":"Department of Gastroenterology and Hepatology Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaividhya","family":"Dasarathy","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Metro Health Medical Center  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Streem","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology Cleveland Clinic Lutheran Hospital  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the AlcHepNet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1774-0104","authenticated-orcid":false,"given":"Srinivasan","family":"Dasarathy","sequence":"additional","affiliation":[{"name":"Department of Inflammation and Immunity Cleveland Clinic  Cleveland Ohio USA"},{"name":"Department of Gastroenterology and Hepatology Cleveland Clinic  Cleveland Ohio USA"},{"name":"Department of Molecular Medicine Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura E.","family":"Nagy","sequence":"additional","affiliation":[{"name":"Department of Inflammation and Immunity Cleveland Clinic  Cleveland Ohio USA"},{"name":"Department of Gastroenterology and Hepatology Cleveland Clinic  Cleveland Ohio USA"},{"name":"Department of Molecular Medicine Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/23247096251316364"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molimm.2017.05.012"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2207599"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.02238"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1128\/MMBR.00177-20"},{"key":"e_1_2_11_7_1","article-title":"Deciphering the Matrisome: Extracellular Matrix Remodeling in Liver Cirrhosis and Hepatocellular Carcinoma","volume":"17","author":"Chaulagain R. 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