Open Access

Objective: Dickkopf 3 (DKK3) has been identified as a urinary biomarker. Values above 4000 pg/mg creatinine (Cr) were linked with a higher risk of short-term decline of kidney function (J Am Soc Nephrol 29: 2722–2733). However, as of today, there is little experience with DKK3 as a risk marker in everyday clinical practice. We used algorithm-based data analysis to evaluate the potential dependence of DKK3 in a cohort from a large single center in Germany. Method: DKK3 was measured in all CKD patients in our center October 1 st 2018 till Dec. 31 2019, together with calculated GFR (eGFR) and urinary albumin/creatinine ratio (UACR). Kidney transplant patients were excluded. Until the end of follow-up Dec 31 st 2021, repeated measurements were performed for all parameters. Data analysis was performed using MD-Explorer (BioArtProducts, Rostock, Germany) and Python with multiple libraries. Linear regression models were applied in patients for DKK3, eGFR and UACR. Comparison of the models was performed with a twosided Kolmogorov-Smirnov test. Results: 1206 DKK3 measurements were performed in 1103 patients (621 male, age 70yrs, eGFR 29,41 ml/min/1.73qm, UACR 800 mg/g). 134 patients died during follow-up. DKK3 mean was 2905 pg/mg Cr (max. 20000, 75 % percentile 3800). 121 pts had DKK3 > 4000. At the end of follow-up 7 % of patients with DKK3 < 4000 (initial eGFR 17.6) versus 39.6 % of patients with DDK3 > 4000 (initial eGFR 15.7) underwent dialysis. Compared to eGFR and UACR at baseline, DKK3 > 4000 performed best to predict eGFR loss over the next 12 months. Conclusion: In this cohort of CKD patients, DKK3 > 4000 at baseline predicted the eGFR slope better than eGFR or UACR at baseline. DKK3 > 4000 reflected a higher risk of progression towards ESRD in patients with similar baseline eGFR levels.

Logging information is more precious as it contains the execution of a system; it is produced by millions of events from simple application logins to random system errors. Most of the security related problems in the cloud ecosystem like intruder attacks, data loss, and denial of service, etc. could be avoided if Cloud Service Provider (CSP) or Cloud User (CU) analyses the logging information. In this paper we introduced few challenges, which are place of monitoring, security, and ownership of the logging information between CSP and CU. Also we proposed a logging architecture to analyze the behaviour of the cloud ecosystem, to avoid data breaches and other security related issues at the CSP space. So that we believe our proposed architecture can provide maximum trust between CU and CSP.