Cargando…

PromarkerD Predicts Renal Function Decline in Type 2 Diabetes in the Canagliflozin Cardiovascular Assessment Study (CANVAS)

The ability of current tests to predict chronic kidney disease (CKD) complicating diabetes is limited. This study investigated the prognostic utility of a novel blood test, PromarkerD, for predicting future renal function decline in individuals with type 2 diabetes from the CANagliflozin CardioVascu...

Descripción completa

Detalles Bibliográficos
Autores principales: Peters, Kirsten E., Xu, Jialin, Bringans, Scott D., Davis, Wendy A., Davis, Timothy M.E., Hansen, Michael K., Lipscombe, Richard J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600174/
https://www.ncbi.nlm.nih.gov/pubmed/33036174
http://dx.doi.org/10.3390/jcm9103212
_version_ 1783603072592773120
author Peters, Kirsten E.
Xu, Jialin
Bringans, Scott D.
Davis, Wendy A.
Davis, Timothy M.E.
Hansen, Michael K.
Lipscombe, Richard J.
author_facet Peters, Kirsten E.
Xu, Jialin
Bringans, Scott D.
Davis, Wendy A.
Davis, Timothy M.E.
Hansen, Michael K.
Lipscombe, Richard J.
author_sort Peters, Kirsten E.
collection PubMed
description The ability of current tests to predict chronic kidney disease (CKD) complicating diabetes is limited. This study investigated the prognostic utility of a novel blood test, PromarkerD, for predicting future renal function decline in individuals with type 2 diabetes from the CANagliflozin CardioVascular Assessment Study (CANVAS). PromarkerD scores were measured at baseline in 3568 CANVAS participants (n = 1195 placebo arm, n = 2373 canagliflozin arm) and used to predict incident CKD (estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m(2) during follow-up in those above this threshold at baseline) and eGFR decline ≥30% during the 4 years from randomization. Biomarker concentrations (apolipoprotein A-IV (apoA4), CD5 antigen-like (CD5L/AIM) and insulin-like growth factor-binding protein 3 (IGFBP3) measured by mass spectrometry were combined with clinical data (age, serum high-density lipoprotein (HDL)-cholesterol, eGFR) using a previously defined algorithm to provide PromarkerD scores categorized as low-, moderate- or high-risk. The participants (mean age 63 years, 33% females) had a median PromarkerD score of 2.9%, with 70.5% categorized as low-risk, 13.6% as moderate-risk and 15.9% as high-risk for developing incident CKD. After adjusting for treatment, baseline PromarkerD moderate-risk and high-risk scores were increasingly prognostic for incident CKD (odds ratio 5.29 and 13.52 versus low-risk, respectively; both p < 0.001). Analysis of the PromarkerD test system in CANVAS shows the test can predict clinically significant incident CKD in this multi-center clinical study but had limited utility for predicting eGFR decline ≥30%.
format Online
Article
Text
id pubmed-7600174
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-76001742020-11-01 PromarkerD Predicts Renal Function Decline in Type 2 Diabetes in the Canagliflozin Cardiovascular Assessment Study (CANVAS) Peters, Kirsten E. Xu, Jialin Bringans, Scott D. Davis, Wendy A. Davis, Timothy M.E. Hansen, Michael K. Lipscombe, Richard J. J Clin Med Article The ability of current tests to predict chronic kidney disease (CKD) complicating diabetes is limited. This study investigated the prognostic utility of a novel blood test, PromarkerD, for predicting future renal function decline in individuals with type 2 diabetes from the CANagliflozin CardioVascular Assessment Study (CANVAS). PromarkerD scores were measured at baseline in 3568 CANVAS participants (n = 1195 placebo arm, n = 2373 canagliflozin arm) and used to predict incident CKD (estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m(2) during follow-up in those above this threshold at baseline) and eGFR decline ≥30% during the 4 years from randomization. Biomarker concentrations (apolipoprotein A-IV (apoA4), CD5 antigen-like (CD5L/AIM) and insulin-like growth factor-binding protein 3 (IGFBP3) measured by mass spectrometry were combined with clinical data (age, serum high-density lipoprotein (HDL)-cholesterol, eGFR) using a previously defined algorithm to provide PromarkerD scores categorized as low-, moderate- or high-risk. The participants (mean age 63 years, 33% females) had a median PromarkerD score of 2.9%, with 70.5% categorized as low-risk, 13.6% as moderate-risk and 15.9% as high-risk for developing incident CKD. After adjusting for treatment, baseline PromarkerD moderate-risk and high-risk scores were increasingly prognostic for incident CKD (odds ratio 5.29 and 13.52 versus low-risk, respectively; both p < 0.001). Analysis of the PromarkerD test system in CANVAS shows the test can predict clinically significant incident CKD in this multi-center clinical study but had limited utility for predicting eGFR decline ≥30%. MDPI 2020-10-06 /pmc/articles/PMC7600174/ /pubmed/33036174 http://dx.doi.org/10.3390/jcm9103212 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Peters, Kirsten E.
Xu, Jialin
Bringans, Scott D.
Davis, Wendy A.
Davis, Timothy M.E.
Hansen, Michael K.
Lipscombe, Richard J.
PromarkerD Predicts Renal Function Decline in Type 2 Diabetes in the Canagliflozin Cardiovascular Assessment Study (CANVAS)
title PromarkerD Predicts Renal Function Decline in Type 2 Diabetes in the Canagliflozin Cardiovascular Assessment Study (CANVAS)
title_full PromarkerD Predicts Renal Function Decline in Type 2 Diabetes in the Canagliflozin Cardiovascular Assessment Study (CANVAS)
title_fullStr PromarkerD Predicts Renal Function Decline in Type 2 Diabetes in the Canagliflozin Cardiovascular Assessment Study (CANVAS)
title_full_unstemmed PromarkerD Predicts Renal Function Decline in Type 2 Diabetes in the Canagliflozin Cardiovascular Assessment Study (CANVAS)
title_short PromarkerD Predicts Renal Function Decline in Type 2 Diabetes in the Canagliflozin Cardiovascular Assessment Study (CANVAS)
title_sort promarkerd predicts renal function decline in type 2 diabetes in the canagliflozin cardiovascular assessment study (canvas)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600174/
https://www.ncbi.nlm.nih.gov/pubmed/33036174
http://dx.doi.org/10.3390/jcm9103212
work_keys_str_mv AT peterskirstene promarkerdpredictsrenalfunctiondeclineintype2diabetesinthecanagliflozincardiovascularassessmentstudycanvas
AT xujialin promarkerdpredictsrenalfunctiondeclineintype2diabetesinthecanagliflozincardiovascularassessmentstudycanvas
AT bringansscottd promarkerdpredictsrenalfunctiondeclineintype2diabetesinthecanagliflozincardiovascularassessmentstudycanvas
AT daviswendya promarkerdpredictsrenalfunctiondeclineintype2diabetesinthecanagliflozincardiovascularassessmentstudycanvas
AT davistimothyme promarkerdpredictsrenalfunctiondeclineintype2diabetesinthecanagliflozincardiovascularassessmentstudycanvas
AT hansenmichaelk promarkerdpredictsrenalfunctiondeclineintype2diabetesinthecanagliflozincardiovascularassessmentstudycanvas
AT lipscomberichardj promarkerdpredictsrenalfunctiondeclineintype2diabetesinthecanagliflozincardiovascularassessmentstudycanvas