Renal function’s impact on serum neurofilament levels in patients with multiple sclerosis: an exploratory analysis

Autores de IIS La Fe

• Jordi Tortosa Carreres

  Autor

• Laura Cubas Núñez

  Autor

• Jéssica Castillo Villalba

  Autor

• Raquel Gasque Rubio

  Autor

• Sara Carratalà Boscà

  Autor

• María Del Carmen Alcalá Vicente

  Autor

• Carlos Quintanilla Bordas

  Autor

• David Gorriz Romero

  Autor

• Bonaventura Casanova Estruch

  Autor

• María Begoña Laiz Marro

  Autor

• Francisco Carlos Pérez Miralles

  Autor

Participantes ajenos a IIS La Fe

• Sanz M.T.

Grupos

• Investigación en Neuroinmunología y Esclerosis Múltiple

Abstract

Background: sNfL, a promising biomarker for neuroaxonal damage in Multiple Sclerosis (MS), requires cautious interpretation due to several comorbidity influences. Objectives: To investigate the impact of renal function on sNfL levels in MS patients. Methods: This retrospective study stratified patients by MS clinical phenotype, acute inflammatory activity (AIA) status—defined as relapse or gadolinium-enhancing lesions within 90 days of sample collection—renal function, assessed by estimated glomerular filtration rate (eGFR), and age (< 40 years, 40–60 years, > 60 years). Comparative analysis of sNfL levels across these groups was performed. The sNfL-eGFR relationship was examined using linear and non-linear regression models, with the best fit determined by R2 and the F estimator. Results: Data from 2933 determinations across 800 patients were analyzed. Patients with renal insufficiency (RI) (eGFR < 60 mL/min/1.73 m2) and mild renal impairment (MDRF) (eGFR 60–90 mL/min/1.73 m2) showed significantly higher sNfL levels compared to those with normal renal function, a pattern also observed in age groups 40 years and older. No significant differences were found between MDRF patients and those with AIA. Among RI patients, no differences in sNfL levels were observed between relapsing-remitting and progressive MS phenotypes. A regression S-Curve model was identified as the best fit, illustrating a marked increase in sNfL levels beginning at an eGFR of approximately 75 mL/min/1.73 m2. Discussion: Caution is advised when interpreting sNfL levels for monitoring MS in patients with impaired renal function. © Fondazione Società Italiana di Neurologia 2024.

Keywords

• Adult; Aged; Biomarkers; Female; Glomerular Filtration Rate; Humans; Male; Middle Aged; Multiple Sclerosis; Neurofilament Proteins; Renal Insufficiency; Retrospective Studies; creatinine; gadolinium; neurofilament protein; polypropylene; biological marker; neurofilament protein; neurofilament protein L; acute inflammatory activity; adult; Article; clinical assessment; comparative study; controlled study; cross-sectional study; female; glomerulus filtration rate; groups by age; human; inflammation; kidney failure; kidney function; limit of quantitation; major clinical study; male; middle aged; mild renal impairment; multiple sclerosis; neurofilament; neurofilament light chain; nonlinear regression analysis; progressive multiple sclerosis; relapse; retrospective study; aged; blood; glomerulus filtration rate; pathophysiology; physiology