Lee AK, Katz R, Jotwani V, et al. - Given that chronic kidney disease represents a strong risk factor for cardiovascular disease (CVD), researchers performed exploratory factor analysis of 10 biomarkers (including 8 biomarkers from urine and 2 from serum) from 2,376 Systolic Blood Pressure Intervention Trial chronic kidney disease participants in order to look at the multiple dimensions of kidney tubular health in correlation with cardiovascular health, as applied methods are required to combine various tubule biomarkers into valuable prognostic scores. In this study, they created summary scores of tubule health dimensions and assessed each tubule score with CVD events, heart failure, and all-cause mortality. They discovered 4 unique dimensions of tubular health: tubule injury/repair (neutrophil gelatinase-associated lipocalin, interleukin 18, chitinase-3-like protein-1), tubule injury/fibrosis (kidney injury molecule-1, monocyte chemoattractant protein-1), tubule reabsorption (α1M microglobulin, β2M microglobulin), and tubular reserve/mineral metabolism (uromodulin, intact parathyroid hormone, intact fibroblast growth factor-23). They found the association of 2 of the 4 tubule scores with CVD, of 1 score with heart failure, and of none with mortality, following adjustment for CVD risk factors, estimated glomerular filtration rate, and albumin-to-creatinine ratio. An improved CVD discrimination beyond contemporary kidney measures was achieved via dimensions of tubule health quantified using factor analysis, in the setting of chronic kidney disease.