Bullen AL, Katz R, Jotwani V, et al. - Given that the impact of intensive vs standard systolic blood pressure targets on cardiovascular morbidity as well as mortality was compared in SPRINT, researchers undertook this ancillary analysis to assess the application of exploratory factor analysis (EFA) to integrate biomarkers of renal tubule health in urine and plasma and then to examine their role in longitudinal eGFR alteration and risk of acute kidney injury (AKI). Four factors, from ten biomarkers, were discovered using EFA. These factors reflected tubule injury/repair [neutrophil gelatinase-associated lipocalin, interleukin-18 and YKL-40 (chitinase-3-like protein)], tubule injury/fibrosis (kidney injury molecule-1 and monocyte chemoattractant protein-1), tubule reabsorption (alpha-1 microglobulin and beta-2 microglobulin), and tubule reserve/mineral metabolism (uromodulin, fibroblast growth factor-23, and parathyroid hormone). A 0.58% faster eGFR reduction was observed in relation to each SD higher tubule reserve/mineral metabolism factor scores; this finding was independent of baseline eGFR and albuminuria. Overall, parsimonious subgrouping of biomarkers into factors, which were differentially related to progressive eGFR reduction and AKI, was enabled by EFA. Pathological processes driving adverse kidney outcomes may be further understood with the help of these subgroups.