A CONNECTION between lung health and kidney function in adults with cystic fibrosis (CF), identifying early urinary markers of kidney injury that correlate with neutrophil activation and reduced lung capacity, has been revealed in a new study. These findings offer new insights into the systemic challenges faced by people with CF (PwCF) and emphasize the need for early detection and management of renal risks.
Key Findings
The study analyzed urinary samples from adult patients with CF and healthy individuals to quantify kidney injury markers, total protein levels, and immune cell activity. Researchers observed a significant increase in urinary protein levels in PwCF, independent of glomerular filtration rate (eGFR). This suggests early-stage kidney damage that may go unnoticed using traditional renal function tests.
Elevated levels of Kidney Injury Molecule-1 (KIM-1) and an increased prevalence of neutrophils among urinary immune cells were strongly associated with diminished lung function. The correlation was particularly pronounced in patients with chronic Pseudomonas aeruginosa infections, a common and severe pulmonary complication in CF. These findings suggest a potential “lung–kidney axis” in CF where chronic lung infections and neutrophil activation contribute to subclinical renal damage.
Clinical Implications
This research underscores the importance of monitoring urinary biomarkers such as KIM-1 in patients with CF, as they may provide an early warning system for kidney injury long before traditional diagnostic tools reveal damage. The association between renal injury and pulmonary health also highlights the need for comprehensive management strategies addressing both lung and kidney health in CF care.
Chronic Pseudomonas infections, which exacerbate lung decline and are now linked to renal injury, present a dual challenge for clinicians. Effective infection control and anti-inflammatory therapies may not only protect lung function but also mitigate kidney risk.
Future Directions
Further studies are needed to explore the mechanisms linking pulmonary disease to kidney injury and to evaluate potential interventions. Meanwhile, integrating routine urinary biomarker assessments into CF management protocols could improve patient outcomes.
Reference: Rosner GM et al. Lung-kidney axis in cystic fibrosis: Early urinary markers of kidney injury correlate with neutrophil activation and worse lung function. J Cyst Fibros. 2025. [Article in press]. doi:10.1016/j.jcf.2024.12.007.
Anaya Malik | AMJ
