Enhorning S, et al. - Plasma copeptin, a marker of vasopressin, is associated with renal function decline in the general population. Herein, the links between elevated copeptin and future risk of kidney disease were determined. Development of both chronic kidney disease (CKD) and other specified kidney diseases was independently predicted by an increased level of copeptin, this finding suggests that copeptin can be used to identify individuals at risk for kidney disease development.

• In a sample of the Malmö Preventive Project (MPP) Reinvestigation (n = 5158) and in the Malmö Diet and Cancer Cardiovascular Cohort (MDC-CC) (n = 5162), copeptin was measured.
• According to national registers, development of chronic kidney disease (CKD) was noted in 89 subjects in MPP and 180 in MDC-CC during follow-up (8.7 and 19.6 years, respectively).

• Copeptin (beta-coefficient per 1 standard deviation increment of ln copeptin) was independently related to increased risk of CKD during follow-up in both cohorts (MPP: (HR) 1.46, 95% confidence interval (CI) 1.18–1.80, P < 0.001; MDC-CC: HR 1.25, 95% CI 1.02–1.54, P=0.03) among subjects free from prevalent kidney disease at baseline, as observed even after multivariate adjustment (gender, age, body mass index, smoking status, estimated glomerular filtration rate, prevalent diabetes, systolic blood pressure and prevalent antihypertensive treatment).
• Furthermore, researchers noted that after multivariate adjustment, elevated copeptin predicted a specified diagnosis of kidney disease other than CKD (HR 1.31, 95% CI 1.08–1.59, P=0.006) in MPP.
• In a corresponding analysis in MDC-CC, they found that copeptin was associated with a 10% increased risk, which, however, was non-significant (P=0.25).
• In addition, a significant association between elevated copeptin and a specified diagnosis of kidney disease other than CKD (HR 1.18, 95% CI 1.05–1.34, P=0.008) was demonstrated by a meta-analysis of the MPP and MDC-CC data.