Plasma Proteins Predict Kidney Function Trajectories in Type 2 Diabetes
Authors' conclusion
Different plasma proteins are associated with progressive and accelerated eGFR decline, independent of traditional cardiorenal risk factors, some of which enhance eGFR trajectory prediction in patients with T2D.
Study context
- Population
- Patients with T2D and relatively preserved kidney function (baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m²), SMART2D and diabetic nephropathy cohorts2 cohorts · SMART2D 1,285 · diabetic nephropathy 798
- Exposure
- eGFR trajectory groups: progressive or accelerated decline vs slow decline
- Outcome
- Plasma proteins associated with eGFR trajectories (1448 proteins analysed, SMART2D)
Methodological detailsproteomic association analysis, latent class mixed models, multivariable logistic regression, validation cohort
- Proteomic association analysis
- Latent class mixed models
- Multivariable logistic regression
- Validation cohort
Main finding
As reported in the abstract
- Proteins associated with accelerated decline
- 19
- KIM-1, accelerated decline: OR (95% CI); P
- 2.95 (2.01-4.32); P = 2.95 × 10-8
- MMP7, accelerated decline: OR (95% CI); P
- 16.5 (5.54-49.07); P = 4.61 × 10-7
- VSIG4, accelerated decline: OR (95% CI); P
- 7.38 (3.22-16.89); P = 2.24 × 10-6
- Proteins associated with progressive decline
- 1
- Protein for progressive decline: OR (95% CI); P
- 6.34 (2.77-14.52); P = 1.26 × 10-5
Observational data: associations, not effects.
Further findings
Progression to end-stage kidney disease
- Highest risk in accelerated decline group (log-rank test)
- P < 0.0001
AUC after adding proteins to clinical risk factors
- Progressive decline: AUC (delta)
- 0.77 (delta 0.04, P = .057)
- Accelerated decline: AUC (delta)
- 0.93 (delta 0.09, P < .001)
- Clinical risk factors: age, sex, ethnicity, eGFR, urine albumin-to-creatinine ratio, HbA1c, diabetes duration, systolic blood pressure, triglyceride
Original publication
Plasma Proteins Predict Kidney Function Trajectories in Type 2 Diabetes. J Clin Endocrinol Metab. Published 14 February 2025. doi:10.
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