1.4 A PROTEOMIC MARKER OF DIABETIC NEPHROPATHY IS ASSOCIATED WITH MORTALITY IN PATIENTS WITH TYPE 2 DIABETES

DOI

10.1016/j.artres.2017.10.018How to use a DOI?

Abstract

Background: The urinary proteomic classifier CKD273 has been found to predict diabetic nephropathy development in advance of microalbuminuria. Whether it is also a determinant of mortality and cardiovascular disease in patients with established albuminuria is unknown.

Methods: We studied 155 subjects with T2D, albuminuria (geometrical mean [IQR]: 85 [34;194] mg/24 hrs), controlled blood pressure (129 ± 16/74 ± 11 mmHg) and preserved renal function (eGFR 88 ± 17 ml/min/1.73 m²). Blood and urine samples were collected for measurement of estimated glomerular filtration rate (eGFR), urine albumin excretion (UAE), N-terminal pro-brain natriuretic peptide (NT-proBNP) and urinary proteomics (capillary electrophoresis coupled to mass spectrometry). Computed tomography imaging was performed to assess coronary artery calcium (CAC) score. Outcome data were collected through national disease registries over a 6 year follow up period.

Results: CKD273 correlated with UAE (r = 0.481, p = <0.001), age (r = 0.238, p = 0.003), CAC score (r = 0.236, p = 0.003), NT-proBNP (r = 0.190, p = 0.018) and eGFR (r = 0.265, p = 0.001). On multiple regression only UAE (β = 0.402, p < 0.001) and eGFR (β = −0.184, p = 0.039) were statistically significant determinants. Twenty participants died during follow-up. CKD273 was a determinant of mortality (log rank [Mantel-Cox] p = 0.004), and retained significance (p = 0.050) after adjustment for age, sex, blood pressure, NT-proBNP and CAC score in a Cox regression model. Neither eGFR nor UAE were determinants of mortality in this cohort.

Conclusions: A multidimensional biomarker can provide information on outcomes associated with its primary diagnostic purpose. Here we demonstrate that the peptidomics-based classifier CKD273 is associated with mortality in albuminuric people with T2D in even when adjusted for other established cardiovascular and renal biomarkers.

Open Access

This is an open access article distributed under the CC BY-NC license.

TY  - JOUR
AU  - Gemma Currie
AU  - Sheon Mary
AU  - Bernt Johan von Scholten
AU  - Morten Kofod Lindhardt
AU  - Harald Mischak
AU  - William Mullen
AU  - Peter Rossing
AU  - Christian Delles
PY  - 2017
DA  - 2017/12/06
TI  - 1.4 A PROTEOMIC MARKER OF DIABETIC NEPHROPATHY IS ASSOCIATED WITH MORTALITY IN PATIENTS WITH TYPE 2 DIABETES
JO  - Artery Research
SP  - 48
EP  - 48
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.018
DO  - 10.1016/j.artres.2017.10.018
ID  - Currie2017
ER  -