Duprez DA, Gross MD, Ix JH, et al. - Among 2,492 participants who were enrolled in the Multi-Ethnic Study of Atherosclerosis, researchers examined long-term renal function decline in correlation with circulating collagen type I carboxy-terminal telopeptide (ICTP) and procollagen type III N-terminal propeptide (PIIINP). These participants were initially aged 45–84 years and were free of clinical cardiovascular disease (CVD). Individuals with estimated glomerular filtration rate (eGFR) less than 60 ml/min per 1.73 m² or urine albumin/creatinine (UAC) at least 30 mg/g were removed from the study. A median 9.4-year follow-up was performed, with primary outcome being renal function decline (≥ 30% decline in eGFR between any two exams or incident UAC ≥ 30 mg/g). Findings revealed a link between high collagen biomarker levels in serum and future reduction in renal function among these study participants who were initially free of CVD and had normal eGFR, this was found consistent with collagen production signaling renal decline. For ICTP, which, unlike PIIINP, is filtered by the kidney, a continuous link was noted, which may owe to its double status as a sensitive marker of glomerular function and collagen degradation.