Afshinnia F, et al. - Researchers intended to better understand the clinical relevance of arachidonic acid (AA) metabolites in chronic kidney disease (CKD) progression. For this purpose, they used a subcohort of Chronic Renal Insufficiency Cohort (CRIC) and compared the concentrations of 85 enzymatic pathway products of AA metabolism in patients with CKD who progressed to end-stage kidney disease (ESKD) vs patients who did not. Additionally, they estimated the risk of CKD progression and major cardiovascular events by levels of AA metabolites and their association with enzymatic metabolic pathways. They found an association between higher odds of CKD progression and higher 20-hydroxyeicosatetraenoate (HETE), lipoxygenase (LOX) and cytochrome P450 (CYP450) metabolic pathways. CKD progression was preceded by these alterations; these may serve as targets for interventions aimed at halting progression.