Inverse association of circulating kallikrein-related peptidase 7 with renal function and mortality risk in patients with chronic kidney disease

To investigate the associations of KLK7 levels with renal function and clinical outcomes in patients with chronic kidney disease (CKD).

Study Design: Cross-sectional and longitudinal analyses were conducted using the Leipzig-CKD cohort, involving 542 patients for baseline KLK7 serum levels and 472 for longitudinal outcomes.
Data Collection: Baseline KLK7 levels were related to renal and cardiometabolic markers, and Cox regression analyses were performed to assess mortality risk.
Gene Expression Analysis: mRNA expression of Klk7 and related genes was examined in CKD versus control mice using bulk RNA sequencing.

KLK7 levels were inversely associated with estimated glomerular filtration rate (eGFR) and C-reactive protein (p<0.001).
Higher baseline KLK7 was linked to lower all-cause mortality (adjusted HR: 0.65 [95% CI: 0.49–0.86], p=0.003) and non-cardiovascular mortality (adjusted HR: 0.56 [95% CI: 0.40–0.78], p=0.001).
A KLK7 threshold of 1383.6 pg/ml stratified patients into low- and high-risk groups for mortality.
No significant associations were found for major adverse renal (MARE) or cardiovascular (MACE) events.

Circulating KLK7 is inversely associated with renal function and inflammation.

Further studies are needed to confirm the associations of KLK7 levels with mortality risk in CKD patients.