{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:11:03Z","timestamp":1791414663900,"version":"4.3.3"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK132155"],"award-info":[{"award-number":["R01DK132155"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK132155"],"award-info":[{"award-number":["R01DK132155"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK132155"],"award-info":[{"award-number":["R01DK132155"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK132155"],"award-info":[{"award-number":["R01DK132155"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK132155"],"award-info":[{"award-number":["R01DK132155"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["JASN"],"published-print":{"date-parts":[[2025,9]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n \n Non-\n DNMT3A<\/jats:italic>\n clonal hematopoiesis of indeterminate potential was associated with CKD progression in a meta-analysis of 5654 individuals with CKD.\n <\/jats:p>\n <\/jats:list-item>\n \n \n In an adenine-induced CKD mouse model,\n Tet2<\/jats:italic>\n -clonal hematopoiesis of indeterminate potential was linked to lower GFR, increased kidney inflammation, tubular injury, and fibrosis.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n \n Clonal hematopoiesis of indeterminate potential (CHIP) is a common inflammatory condition of aging that causes myriad end-organ damage. CHIP has been associated with incident AKI and kidney function decline in the general population, particularly mutations in CHIP genes other than\n DNMT3A<\/jats:italic>\n (termed non-\n DNMT3A<\/jats:italic>\n CHIP). Previous studies of CHIP in individuals with CKD had limited sample sizes and conflicting findings.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We examined CHIP and CKD progression in four CKD cohorts (\n N<\/jats:italic>\n =5654): the Chronic Renal Insufficiency Cohort, the African American Study of Kidney Disease, individuals with CKD from the BioVU biorepository, and the Canadian Study of Prediction of Death, Dialysis and Interim Cardiovascular Events. Primary outcomes were incident CKD progression (50% eGFR decline or kidney failure) and eGFR slope over time. In addition, kidney function and pathology were assessed in a\n Tet2<\/jats:italic>\n -CHIP mouse model of CKD induced by dietary adenine.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Across all cohorts, the average age was 66\u00b111 years, with an average baseline eGFR of 43\u00b115 ml\/min per 1.73 m\n 2<\/jats:sup>\n , and 24% had CHIP. After meta-analysis, non-\n DNMT3A<\/jats:italic>\n CHIP was associated with a 64% higher relative risk of incident CKD progression (hazard ratio, 1.64; 95% confidence interval, 1.00 to 2.68), with the strongest effect observed in individuals with baseline eGFR 30\u201360 ml\/min per 1.73 m\n 2<\/jats:sup>\n (hazard ratio, 1.85; 95% confidence interval, 1.18 to 2.90). Non-\n DNMT3A<\/jats:italic>\n CHIP carriers also exhibited a faster eGFR decline (\n \u03b2<\/jats:italic>\n , \u22120.62\u00b10.28 ml\/min per 1.73 m\n 2<\/jats:sup>\n per year;\n P<\/jats:italic>\n = 0.03). In a dietary adenine mouse model of CKD,\n Tet2<\/jats:italic>\n -CHIP was associated with lower GFR as well as greater kidney inflammation, tubular injury, and tubulointerstitial fibrosis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Non-\n DNMT3A<\/jats:italic>\n CHIP was associated with CKD progression among individuals with CKD. Furthermore,\n Tet2<\/jats:italic>\n -CHIP mouse models support a causal role in kidney injury.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1681\/asn.0000000680","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T12:06:46Z","timestamp":1744200406000},"page":"1764-1774","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":23,"title":["Clonal Hematopoiesis of Indeterminate Potential and Progression of CKD"],"prefix":"10.1681","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8466-7602","authenticated-orcid":false,"given":"Caitlyn","family":"Vlasschaert","sequence":"first","affiliation":[{"name":"Department of Medicine, Queen's University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3487-7233","authenticated-orcid":false,"given":"Yang","family":"Pan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9438-1638","authenticated-orcid":false,"given":"Jianchun","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9572-9184","authenticated-orcid":false,"given":"Elvis","family":"Akwo","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6594-0536","authenticated-orcid":false,"given":"Varun","family":"Rao","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0849-9315","authenticated-orcid":false,"given":"James E.","family":"Hixson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0555-4622","authenticated-orcid":false,"given":"Michael","family":"Chong","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton, Ontario, Canada"},{"name":"Thrombosis and Atherosclerosis Research Institute, David Barley Cardiac, Vascular and Stroke Research, Hamilton, Ontario, Canada"},{"name":"Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1846-0411","authenticated-orcid":false,"given":"Md Mesbah","family":"Uddin","sequence":"additional","affiliation":[{"name":"Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4810-3474","authenticated-orcid":false,"given":"Zhi","family":"Yu","sequence":"additional","affiliation":[{"name":"Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts"},{"name":"Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4805-0504","authenticated-orcid":false,"given":"Mengdi","family":"Jiang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2737-1971","authenticated-orcid":false,"given":"Fenfen","family":"Peng","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6593-4600","authenticated-orcid":false,"given":"Shirong","family":"Cao","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0850-6941","authenticated-orcid":false,"given":"Yinqiu","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7524-2379","authenticated-orcid":false,"given":"Do-Kyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3203-1608","authenticated-orcid":false,"given":"Adriana M.","family":"Hung","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"He","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5227-2479","authenticated-orcid":false,"given":"Manjula Kurella","family":"Tamura","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1325-315X","authenticated-orcid":false,"given":"Debbie L.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8286-9652","authenticated-orcid":false,"given":"Jiang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changwei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1960-1730","authenticated-orcid":false,"given":"Zeenat","family":"Bhat","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Nephrology, University of Michigan Health System, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4699-5395","authenticated-orcid":false,"given":"Panduranga","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Nephrology, University of Michigan Health System, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawei","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5824-9595","authenticated-orcid":false,"given":"Alexander G.","family":"Bick","sequence":"additional","affiliation":[{"name":"Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Kestenbaum","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Kidney Research Institute, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6795-4760","authenticated-orcid":false,"given":"Guillaume","family":"Par\u00e9","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton, Ontario, Canada"},{"name":"Thrombosis and Atherosclerosis Research Institute, David Barley Cardiac, Vascular and Stroke Research, Hamilton, Ontario, Canada"},{"name":"Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8346-5537","authenticated-orcid":false,"given":"Michael J.","family":"Rauh","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-8401","authenticated-orcid":false,"given":"Adeera","family":"Levin","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8402-7435","authenticated-orcid":false,"given":"Pradeep","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts"},{"name":"Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6580-4080","authenticated-orcid":false,"given":"James P.","family":"Lash","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois Chicago, Chicago, 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Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5750-6286","authenticated-orcid":false,"given":"Matthew B.","family":"Lanktree","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton, Ontario, Canada"},{"name":"Division of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7348-4451","authenticated-orcid":false,"given":"Tanika N.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Chronic Renal Insufficiency Cohort (CRIC) Study Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"issue":"26","key":"B1-20260130","doi-asserted-by":"crossref","first-page":"2488","DOI":"10.1056\/NEJMoa1408617","article-title":"Age-related clonal hematopoiesis associated with adverse outcomes","volume":"371","author":"Jaiswal","year":"2014","journal-title":"New Engl J Med."},{"issue":"1","key":"B2-20260130","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1182\/blood-2015-03-631747","article-title":"Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes","volume":"126","author":"Steensma","year":"2015","journal-title":"Blood."},{"issue":"7831","key":"B3-20260130","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1038\/s41586-020-2819-2","article-title":"Inherited causes of clonal haematopoiesis in 97,691 whole 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