Urinary Sclerostin and Renal Magnesium Handling in Proteinuric Non-Diabetic Chronic Kidney Disease.

Authors

Ching Fang Wu, Te-Hui Kuo, An-Bang Wu, Wei-Hung Lin, Jo-Yen Chao, Shih-Yuan Hung, Chin-Chung Tseng, Hung-Hsiang Liou, Ming-Cheng Wang

Published in

Kidney & blood pressure research. Pages 1. Sep 07, 2026. Epub Sep 07, 2026.

Abstract

Sclerostin is involved in chronic kidney disease-mineral and bone disorder (CKD-MBD), but its relation to renal magnesium handling remains unclear. We investigated whether urinary and serum sclerostin were associated with fractional excretion of magnesium (FeMg) in proteinuric non-diabetic chronic kidney disease (CKD).
In this cross-sectional study, 70 adults with proteinuric non-diabetic CKD stage 1 to 5 at a tertiary medical center were enrolled. Urinary sclerostin normalized to urine creatinine (Uscl/Ucre) and serum sclerostin were measured. Their associations with ln-transformed FeMg [ln(FeMg)] were examined using multivariable linear regression with sequential adjustment for age, sex, estimated glomerular filtration rate (eGFR), proteinuria, electrolytes, serum sclerostin, and CKD-MBD markers including plasma intact parathyroid hormone, serum fibroblast growth factor 23, and soluble alpha-Klotho.
Urinary sclerostin (Uscl/Ucre) increased across CKD stages, and higher Uscl/Ucre tertiles were associated with higher FeMg. Uscl/Ucre was positively associated with ln(FeMg) in crude analysis (β 0.652; p < 0.001) and this association still existed after adjustment for age, sex, eGFR, serum magnesium, and CKD-MBD markers (β 0.366; p < 0.001). Compared with the lowest tertile, the highest urinary sclerostin tertile was significantly associated with higher ln(FeMg) (β 0.662; p = 0.007). In contrast, serum sclerostin was not associated with ln(FeMg) after adjustment.
In proteinuric non-diabetic chronic kidney disease, urinary but not serum sclerostin is independently associated with fractional excretion of magnesium. Urinary sclerostin may reflect intrarenal processes relevant to tubular magnesium handling.

PMID:
42704754
Bibliographic data and abstract were imported from PubMed on 08 Sep 2026.

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