Metabolome-derived kidney function scores as prognostic readouts of cardiovascular-kidney-metabolic health.

Metabolomic kidney function gaps (mKFGs) predict future cardiovascular-kidney-metabolic events and all-cause mortality beyond creatinine-based eGFRcr in MetaCardis (N=1,723) and external cohorts.

• Why it matters: Creatinine-based eGFRcr is influenced by non-renal factors and may miss earlier kidney dysfunction, leaving a gap in prognostic readouts for the cardiovascular-kidney-metabolic (CKM) syndrome.
• What they did: Using MetaCardis metabolomics, the study computed mKFGs as the difference between metabolome-predicted and measured eGFRcr, then built sex-stratified metabolite panels (40–98 of 1,514) via physiology-guided feature selection anchored on haemoglobin, albumin, and the Neutrophil-to-Lymphocyte Ratio.
• The result: In Canadian Longitudinal Study on Aging (N=9,958) and German Chronic Kidney Disease Study (N=5,113), mKFGs provided incremental predictive value for CKM events and all-cause mortality beyond eGFRcr and established risk equations.

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