| Title: | Clonal Hematopoiesis of Indeterminate Potential and Kidney Failure in Chronic Kidney Disease: An East Asian Cohort Study. |
| Journal: | Clinical Journal of the American Society of Nephrology |
| Published: | 11 Jun 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42275156/ |
| DOI: | https://doi.org/10.2215/cjn.0000001092 |
Publication 20834
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Abstract
BACKGROUND: Clonal hematopoiesis of indeterminate potential (CHIP) is an age-related condition associated with inflammation. Although chronic kidney disease (CKD) shares these pathophysiological features, the prognostic role of CHIP on CKD progression remains unclear, particularly in underrepresented East Asian populations.</p>
METHODS: Deep-targeted sequencing of CHIP-driving mutations was used to identify the presence of CHIP, defined as variant allele fraction (VAF) ≥2.0%. CHIP prevalence was compared between 175 Korean patients with CKD in the KNOW-CKD cohort and 700 matched general population controls in the GENIE cohort. The association between CHIP and kidney failure (KF) risk was evaluated using multivariable Cox regression analysis both in the KNOW-CKD cohort and 232 matched UK Biobank participants with CKD. Furthermore, VAF was compared between CHIP-positive participants in the KNOW-CKD and GENIE cohorts.</p>
RESULTS: The prevalence of CHIP was significantly higher in the KNOW-CKD than in the GENIE cohort (17% vs. 11%; P = 0.04). Over a median follow-up of 10.0 years, 66 patients (38%) developed KF in the KNOW-CKD cohort. After multivariable adjustment, CHIP was associated with higher risk of KF (adjusted hazard ratio [aHR], 1.90; 95% CI, 1.03-3.51). Furthermore, in the UK Biobank, KF occurred in 43 participants (20%) over a median follow-up of 12.9 years and the association of CHIP with higher risk of KF was consistently observed (aHR, 2.16; 95% CI, 1.15-4.03). Furthermore, among CHIP-positive participants, the median VAF of CHIP-associated mutations was significantly higher in persons within the KNOW-CKD cohort compared to healthy controls in the GENIE cohort (7.3% vs. 4.4%; P = 0.02).</p>
CONCLUSIONS: CHIP is more prevalent in patients with CKD and serves as an independent risk factor for KF. This association is consistently observed across both an underrepresented East Asian cohort and a European cohort, establishing CHIP as a globally relevant risk factor for CKD progression.</p>
13 Authors
- Minsang Kim
- Sanyeowool An
- Hyunjin Ryu
- Choonghyun Sun
- Hong Yul An
- Gangpyo Ryu
- Jayoun Kim
- Yaeni Kim
- Soo Wan Kim
- Yeong Hoon Kim
- Siddhartha Jaiswal
- Youngil Koh
- Kook-Hwan Oh
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