{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T11:44:25Z","timestamp":1783943065502,"version":"3.55.0"},"reference-count":16,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: A novel post-translational modification (PTM) fragment derived from the cleavage of Fetuin-A (PTM-FetA) has recently emerged as a sensitive biomarker for kidney damage in diabetic patients, but evidence in other chronic renal diseases is lacking. In this pilot study, we aimed at evaluating the clinical significance of urinary PTM-FetA (uPTM-FetA) in a mixed cohort of patients with non-advanced chronic kidney disease (CKD) secondary to diabetic kidney disease (DKD) or other causes. Materials and Methods: We enrolled 47 adult patients with CKD (mean CKD-Epi 40.10 \u00b1 16.5 mL\/min\/1.73 m2) due to DKD (n = 34) or other etiology (n = 13). uPTM-FetA was measured in the urine using a commercially available ELISA kit. Fifteen healthy individuals served as controls. Results: Collectively, all CKD patients displayed remarkably higher levels of uPTM-FetA than controls (0.84 [0.10\u20131.15] vs. 29.68 [2.50\u201355.16] ng\/mL p = 0.0005), but values were lower in non-DKD than in DKD patients (1.66 [0.09\u20134.19] vs. 13.9 [0.01\u201345.02] ng\/mL; p = 0.01). uPTM-FetA showed a great diagnostic capacity at ROC analyses to identify the presence of CKD (AUC 0.776; p &lt; 0.001) and, within CKD patients, to discriminate the diabetic and non-diabetic etiology (AUC 0.673; p = 0.02). At multivariate correlation analyses, proteinuria (\u03b2 = 0.442; p = 0.02) and BMI (\u03b2 = \u22120.334; p = 0.04) were the sole independent predictors of uPTM-FetA in this study population. Conclusions: uPTM-FetA could be a novel sensitive biomarker at the crossroad of chronic renal damage and metabolic dysfunction. Additionally, this biomarker could also represent a non-invasive, complementary tool for discriminating among different CKD etiologies (DKD vs. non-DKD) in difficult cases or when renal biopsy is not available.<\/jats:p>","DOI":"10.3390\/medicina60030363","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T10:52:00Z","timestamp":1708512720000},"page":"363","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Urinary Post-Translationally Modified Fetuin-A (uPTM-FetA) in Chronic Kidney Disease Patients with and without Diabetic Kidney Disease"],"prefix":"10.3390","volume":"60","author":[{"given":"Michela","family":"Musolino","sequence":"first","affiliation":[{"name":"Nephrology and Dialysis Unit, Magna Graecia University Hospital, 88100 Catanzaro, Italy"},{"name":"Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4192-3891","authenticated-orcid":false,"given":"Marta","family":"Greco","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy"},{"name":"Clinical Pathology Lab., Magna Graecia University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"D\u2019Agostino","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Magna Graecia University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loredana","family":"Tripodi","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Magna Graecia University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Misiti","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy"},{"name":"Clinical Pathology Lab., Magna Graecia University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Dragone","sequence":"additional","affiliation":[{"name":"Clinical Pathology Lab., Magna Graecia University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Cianfrone","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Magna Graecia University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariateresa","family":"Zicarelli","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9536-5736","authenticated-orcid":false,"given":"Daniela Patrizia","family":"Foti","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy"},{"name":"Clinical Pathology Lab., Magna Graecia University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7974-3792","authenticated-orcid":false,"given":"Michele","family":"Andreucci","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Magna Graecia University Hospital, 88100 Catanzaro, Italy"},{"name":"Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3032-245X","authenticated-orcid":false,"given":"Davide","family":"Bolignano","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Magna Graecia University Hospital, 88100 Catanzaro, Italy"},{"name":"Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8000-0681","authenticated-orcid":false,"given":"Giuseppe","family":"Coppolino","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Magna Graecia University Hospital, 88100 Catanzaro, Italy"},{"name":"Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,21]]},"reference":[{"key":"ref_1","unstructured":"GBD Chronic Kidney Disease Collaboration (2020). 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