Higher serum lactate dehydrogenase (LDH) levels are significantly associated with worse renal and cardiovascular outcomes in patients with advanced chronic kidney disease (CKD) who do not have diabetes, according to a new study. The research, an analysis of the PREDICT trial cohort, was published in the American Journal of Kidney Diseases in 2025.
The study analyzed data from over 1,300 participants with advanced CKD (stages 3b-5) and no diabetes. Researchers found that for every 50-unit per liter increase in LDH, there was a 13% higher risk of the primary composite kidney outcome, which included a 50% decline in kidney function, progression to kidney failure requiring dialysis, or death from kidney disease.
Furthermore, elevated LDH was independently linked to a higher risk of major adverse cardiovascular events (MACE), such as heart attack or stroke. LDH is an enzyme released during cell damage, and its elevation in this context is thought to reflect systemic inflammation and cellular stress, which are key drivers of disease progression in CKD.
The findings suggest that LDH could serve as a simple, widely available biomarker to help identify non-diabetic CKD patients at the highest risk for rapid disease progression and cardiovascular complications, potentially allowing for more targeted monitoring and intervention.
