Three specific proteins predict the risk of diabetic nephropathy

Diabetes can cause a wide range of complications such as retinopathy, neuropathy, and nephropathy, which are responsible for considerable morbidity. Diabetic nephropathy, also known as diabetic kidney disease, is a frequent complication of type 2 diabetes. It occurs when kidney filtration function is damaged and is characterized by nephrotic syndrome and diffuse scarring of the glomeruli. Early diabetic kidney disease often has no symptoms while the advanced disease may trigger severe tiredness, headaches, nausea, vomiting, leg swelling.

Pathophysiologic mechanisms of diabetic kidney disease are incompletely understood. In addition, there is a lack of biomarkers that can be used to predict individual disease risk. Now a group of researchers, headed by Prof. Chirag Parikh at Yale University School of Medicine, has identified three proteins that may act as biomarkers of both early and established diabetic kidney disease. Findings of the study are published in the Journal of the American Society of Nephrology.

To identify biomarkers of diabetic kidney disease, Parikh's team used plasma samples from patients with early and advanced diabetic kidney disease. The levels of three specific proteins, TNF receptor–1 (TNFR-1), TNFR-2, and kidney injury molecule–1 (KIM-1), were measured. By comparing the levels of these proteins and decline in kidney filtration function, the researchers found that TNFR-1, TNFR-2, and KIM-1 independently associated with higher risk of kidney function decline in the patients. Collectively, the data suggest that the three proteins may be useful in predicting kidney disease progression in individuals with diabetes. Additionally, measurement of these biomarkers could be an approach to evaluate treatment effectiveness.
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