Article Dans Une Revue Kidney International Reports Année : 2022

Machine Learning-Based Urine Peptidome Analysis to Predict and Understand Mechanisms of Progression to Kidney Failure

Harald Mischak
Yves Édouard Herpe
Natália Alencar de Pinho
  • Fonction : Auteur
Carole Ayav
  • Fonction : Auteur
Dorothée Cannet
  • Fonction : Auteur
Christian Combe
Jean François Deleuze
  • Fonction : Auteur
Denis P. Fouque
  • Fonction : Auteur
Luc Frimat
  • Fonction : Auteur
Christian Jacquelinet
Maurice Laville
  • Fonction : Auteur
Sophie Liabeuf
Christophe Pascal
Bruce M. Robinson
Roberto Flávio Silva Pecoits-Filho
Céline Lange
  • Fonction : Auteur
Elodie Speyer

Résumé

Introduction: The identification of patients with chronic kidney disease (CKD) at risk of progressing to kidney failure (KF) is important for clinical decision-making. In this study we assesed whether urinary peptidome (UP) analysis may help classify patients with CKD and improve KF risk prediction. Methods: The UP was analyzed using capillary electrophoresis coupled to mass spectrometry in a case-cohort sample of 1000 patients with CKD stage G3 to G5 from the French CKD-Renal Epidemiology and Information Network (REIN) cohort. We used unsupervised and supervised machine learning to classify patients into homogenous UP clusters and to predict 3-year KF risk with UP, respectively. The predictive performance of UP was compared with the KF risk equation (KFRE), and evaluated in an external cohort of 326 patients. Results: More than 1000 peptides classified patients into 3 clusters with different CKD severities and etiologies at baseline. Peptides with the highest discriminative power for clustering were fragments of proteins involved in inflammation and fibrosis, highlighting those derived from α-1-antitrypsin, a major acute phase protein with anti-inflammatory and antiapoptotic properties, as the most significant. We then identified a set of 90 urinary peptides that predicted KF with a c-index of 0.83 (95% confidence interval [CI]: 0.81−0.85) in the case-cohort and 0.89 (0.83−0.94) in the external cohort, which were close to that estimated with the KFRE (0.85 [0.83−0.87]). Combination of UP with KFRE variables did not further improve prediction. Conclusion: This study shows the potential of UP analysis to uncover new pathophysiological CKD progression pathways and to predict KF risk with a performance equal to that of the KFRE.

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hal-04194829 , version 1 (31-03-2025)

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Ziad André Massy, Oriane Lambert, Marie Metzger, Mohammed Sedki, Adeline Chaubet, et al.. Machine Learning-Based Urine Peptidome Analysis to Predict and Understand Mechanisms of Progression to Kidney Failure. Kidney International Reports, 2022, 8 (3), pp.544-555. ⟨10.1016/j.ekir.2022.11.023⟩. ⟨hal-04194829⟩
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