4.7 Article

A Mendelian randomization study found causal linkage between telomere attrition and chronic kidney disease

Journal

KIDNEY INTERNATIONAL
Volume 100, Issue 5, Pages 1063-1070

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.kint.2021.06.041

Keywords

aging; chronic kidney disease; Mendelian randomization; telomere

Funding

  1. Industrial Strategic Technology Development Program- Development of Biocore Technology - Ministry of Trade, Industry and Energy (Korea) [10077474]
  2. SNU RDB Foundation [800-20190571]
  3. Korea Evaluation Institute of Industrial Technology (KEIT) [10077474] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)

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The research indicates a causal relationship between telomere attrition and kidney function impairment. Genetic predisposition towards telomere attrition is associated with a higher risk of chronic kidney disease, while a genetically predicted kidney function decrease is linked to an increase in telomere attrition.
Chronic kidney disease (CKD) is highly prevalent in the elderly population. However, it is rarely investigated whether kidney function is causally linked to biological aging itself. In this Mendelian randomization study, genetic instruments for telomere attrition were applied to a CKDGen genome wide association study results for 41,395 cases of CKD among 480,698 individuals as summary-level Mendelian randomization. A replicative analysis was performed by polygenic score analysis using independent United Kingdom Biobank data for 8,118 cases of CKD among 321,024 white individuals of British ancestry. Reverse-direction Mendelian randomization analysis was performed utilizing genetic instruments for log-estimated glomerular filtration rate change with Z-standardized telomere length outcome data for 326,075 participants in the UK Biobank. Genetic predisposition toward telomere attrition (one Z score decrease in length) was found to be a causative factor for a higher CKD risk [Odds Ratio 1.20 (95% confidence interval 1.08-1.33)], as supported by pleiotropy-robust Mendelian randomization sensitivity analyses implemented using the CKDGen data. Based on United Kingdom Biobank data, the polygenic score for telomere attrition was significantly associated with a higher risk of CKD [1.20 (1.04-1.39)]. In reverse-direction Mendelian randomization, the genetically predicted kidney function decrease was significantly associated with a higher degree of telomere attrition [beta 0.039 (0.009-0.069)]. Thus, our study supports the causal linkage between telomere attrition and kidney function impairment.

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