Urinary collagen degradation marker may predict kidney function decline during peptide radionuclide therapy
Urinary C3M (type III collagen degradation marker) was significantly lower at specific time points in NET patients who subsequently lost >25% kidney function during PRRT, suggesting potential as a prognostic biomarker.
Quick Facts
What This Study Found
uC3M significantly lower in kidney-decline patients after 1st treatment (74 vs 135 ng/mg) and 3 months post-EOT (56 vs 118 ng/mg). 43% (6/14) had >25% kidney function decline. Median follow-up 12 months. Other fibrosis markers (PRO-C3, PRO-C6) not significantly different.
Key Numbers
How They Did This
Prospective cohort of 14 NEN patients undergoing PRRT. Serum and urine fibrosis markers (PRO-C3, PRO-C6, C3M) measured before and after each treatment. Kidney function tests through 24 months post-EOT. Linear mixed models.
Why This Research Matters
Kidney damage from PRRT is irreversible. A urine biomarker that predicts who will lose kidney function could enable protective interventions or dose adjustments before permanent damage occurs.
The Bigger Picture
Biomarker-guided PRRT could personalize treatment intensity—protecting kidneys in susceptible patients while maintaining oncological efficacy.
What This Study Doesn't Tell Us
Very small sample (14 patients). Exploratory analysis. Overall mixed model only marginally significant (p=0.078). Needs larger validation study.
Questions This Raises
- ?Can uC3M guide dose adjustments during PRRT?
- ?Should routine uC3M monitoring be implemented for PRRT patients?
- ?Would kidney-protective strategies (hydration, amino acid infusion) help patients with low uC3M?
Trust & Context
- Key Stat:
- uC3M predicts kidney decline Lower urinary collagen degradation marker after first PRRT treatment identified patients who subsequently lost >25% kidney function
- Evidence Grade:
- Small exploratory prospective study. Promising biomarker signal needing validation in larger cohorts.
- Study Age:
- Published in 2025.
- Original Title:
- Fibrosis markers as prognostic markers of decline in kidney function in patients with neuroendocrine neoplasms undergoing peptide receptor radionuclide therapy.
- Published In:
- Frontiers in endocrinology, 16, 1495369 (2025)
- Authors:
- Stemann Lau, Tobias, Bossen, Lars, Rasmussen, Daniel Guldager Kring, Genovese, Federica, Karsdal, Morten, Arveschoug, Anne Kirstine, Grønbæk, Henning, Dam, Gitte
- Database ID:
- RPEP-13680
Evidence Hierarchy
Frequently Asked Questions
Can PRRT damage the kidneys?
Yes, kidney function decline is a recognized side effect of PRRT because the radiolabeled peptides are filtered through the kidneys. In this study, 43% of patients lost more than 25% of kidney function. A urine test (C3M) may help identify at-risk patients early.
What is C3M?
C3M is a fragment released when type III collagen is broken down. Lower levels in urine suggest less collagen degradation (fibrolysis) and potentially more fibrosis accumulation in the kidneys. Patients with lower uC3M after PRRT were more likely to lose kidney function.
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Cite This Study
https://rethinkpeptides.com/research/RPEP-13680APA
Stemann Lau, Tobias; Bossen, Lars; Rasmussen, Daniel Guldager Kring; Genovese, Federica; Karsdal, Morten; Arveschoug, Anne Kirstine; Grønbæk, Henning; Dam, Gitte. (2025). Fibrosis markers as prognostic markers of decline in kidney function in patients with neuroendocrine neoplasms undergoing peptide receptor radionuclide therapy.. Frontiers in endocrinology, 16, 1495369. https://doi.org/10.3389/fendo.2025.1495369
MLA
Stemann Lau, Tobias, et al. "Fibrosis markers as prognostic markers of decline in kidney function in patients with neuroendocrine neoplasms undergoing peptide receptor radionuclide therapy.." Frontiers in endocrinology, 2025. https://doi.org/10.3389/fendo.2025.1495369
RethinkPeptides
RethinkPeptides Research Database. "Fibrosis markers as prognostic markers of decline in kidney ..." RPEP-13680. Retrieved from https://rethinkpeptides.com/research/stemann-2025-fibrosis-markers-as-prognostic
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.