What question did this study set out to answer?

The study aims to explore whether plasma levels of MCP-1 are associated with kidney and cardiovascular outcomes in individuals with CKD.

January 10, 2026BMC Nephrology0 citationsOpen Access

Plasma monocyte chemoattractant protein-1 and the risk of kidney and cardiovascular outcomes in people with chronic kidney disease: results from the BRIGHTEN study

TTTakuji ToyamaCardiac Imaging TKTatsuo KagimuraTranslational Research Informatics Center (Japan)KTKenichiro TanabeSt. Marianna University School of Medicine

Key Result

In patients with CKD, higher plasma MCP-1 levels are associated with an additional eGFR decline of approximately 1.0 mL/min/1.73 m² per year compared to the lowest MCP-1 group.

Key Points

The study aims to explore whether plasma levels of MCP-1 are associated with kidney and cardiovascular outcomes in individuals with CKD.
Multicenter, prospective, observational analysis from the BRIGHTEN study.
Participants with anemia and CKD were grouped based on quartiles of baseline plasma MCP-1 levels.
Primary outcomes assessed included kidney outcomes, annual eGFR decline, cardiovascular outcomes, and mortality.
Associations were evaluated using Cox proportional hazard and linear mixed-effects models.
1,447 participants with advanced CKD were included, median eGFR was 17.9 mL/min/1.73 m².
Higher MCP-1 levels were linked to increased risk of kidney and cardiovascular outcomes in univariable analysis.
Higher MCP-1 was associated with an additional eGFR decline of about 1.0 mL/min/1.73 m² per year compared to the lowest group.
No significant association was found between MCP-1 levels and mortality.

Structured PICO

Do higher plasma MCP-1 levels predict kidney and cardiovascular outcomes in patients with advanced chronic kidney disease?

Population

1,447 participants with anemia and advanced chronic kidney disease (eGFR < 60 mL/min/1.73 m2, median eGFR 17.9) initiating darbepoetin alfa treatment, mean age 69.8 years, 58.7% male, across 168 centers in Japan.

Intervention

Higher baseline plasma monocyte chemoattractant protein-1 (MCP-1) levels (stratified into quartiles Q2-Q4)

Comparator

Lowest quartile of baseline plasma MCP-1 levels (Q1: < 324.5 pg/mL)

Outcome

Composite kidney outcomes (maintenance dialysis initiation, kidney transplantation, 50% eGFR decline, or eGFR ≤ 6 mL/min/1.73 m2), annual eGFR decline rate, cardiovascular outcomes (composite of fatal and non-fatal CV events), and all-cause mortalitycomposite

In patients with advanced CKD, higher plasma MCP-1 levels are associated with a more rapid decline in kidney function but do not independently predict composite kidney failure, cardiovascular outcomes, or mortality.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background Monocyte chemoattractant protein-1 (MCP-1) has been implicated in the pathogenesis of chronic kidney disease (CKD); however, its clinical significance in CKD remains unclear. This study investigated the association between plasma MCP-1 levels and kidney and cardiovascular outcomes in patients with CKD. Methods This multicenter, prospective, observational analysis used data from the BRIGHTEN study. Participants with anemia and CKD (eGFR < 60 mL/min/1.73 m 2 ) were classified into four groups based on quartiles of their baseline plasma MCP-1 levels. The primary outcomes included kidney outcomes (a composite of initiation of maintenance dialysis, kidney transplantation, 50% decline in eGFR, or eGFR ≤ 6 mL/min/1.73 m 2 ), the annual rate of eGFR decline, cardiovascular outcomes, and all-cause mortality. Associations were assessed using Cox proportional hazard and linear mixed-effects models. Results This study included 1,447 participants with advanced CKD (median eGFR 17.9 mL/min/1.73 m²). The group with the lowest MCP-1 level (< 324.5 pg/mL) had the highest baseline eGFR. In the univariable analyses, higher MCP-1 levels were associated with an increased risk of kidney and cardiovascular outcomes (log-rank p < 0.01 and p = 0.03, respectively), although these associations were not significant after multivariable adjustment. Analysis of the annual eGFR decline using a multivariable linear mixed-effects model revealed that higher MCP-1 levels were associated with an additional eGFR decline of approximately 1.0 mL/min/1.73 m 2 per year compared to the lowest MCP-1 group. MCP-1 levels were not associated with mortality. Conclusions In patients with CKD, higher plasma MCP-1 levels are associated with a more rapid decline in kidney function but not with the composite outcome of kidney failure. MCP-1 was not associated with cardiovascular outcomes or mortality in this population cohort.

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