Discovery could help to predict progression of diabetic kidney disease

Jack Woodfield
Tue, 23 Apr 2019
Discovery could help to predict progression of diabetic kidney disease
A US study has identified a key finding which could help people with diabetic kidney disease (DKD) avoid future damage.

The Joslin Diabetes Center has identified a group of proteins which could be used to help doctors to determine the risk of end-stage renal (kidney) disease among those with DKD, also known as diabetic nephropathy.

The researchers discovered 17 circulating inflammatory proteins that were involved in the progression to end-stage renal disease in both people with type 1 diabetes and type 2 diabetes.

The trial involved monitoring 219 people with type 1 diabetes and 144 people with type 2 diabetes who all had kidney disease for up to 7-15 years and 10-15 years respectively.

A group of Pima Indian people with type 2 diabetes were also included in the study to assess variances in race backgrounds.

More than 200 circulating inflammatory proteins were studied and researchers found the same 17 played a vital role in the progression of DKD to end-stage renal disease in all groups.

"The finding is amazing," said senior study author Andrzej Krolewski, head of Genetics and Epidemiology at Joslin and Professor of Medicine at Harvard Medical School.

"It looks like inflammatory processes the underlie progression to end stage renal disease are similar across two diabetes types and differing race backgrounds. The disease process is very homogenous."

The team also discovered that the inflammatory proteins do not originate in the kidney, which suggests there is another process working alongside that contributes to the disease progression.

None of the 17 proteins identified were found to be associated with diabetic eye disease (retinopathy).

"It was a comprehensive and unbiased evaluation on the role of almost all the known circulating inflammatory proteins, in contrary to what was done before where people were looking at a few candidate proteins," said Monika Niewczas, Assistant Investigator at Joslin and Assistant Professor of Medicine at Harvard Medical School.

"What we found was that there are very specific components of inflammation that are key drivers of the process, and this concept may have not been appreciated before."

The study findings have been published in the Nature Medicine journal.
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