Abstract: TH-PO176
Baseline and Short-Term Change of Concentration of Plasma Proteins Measured by Joslin Kidney Panel and Progression to ESKD in the Chronic Renal Insufficiency Cohort (CRIC)
Session Information
- Diabetic Kidney Disease: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Kobayashi, Hiroki, Joslin Diabetes Center, Boston, United States
- Md Dom, Zaipul, Joslin Diabetes Center, Boston, Massachusetts, United States
- Satake, Eiichiro, Joslin Diabetes Center, Boston, Massachusetts, United States
- Lash, James P., University of Illinois Chicago, Chicago, Illinois, United States
- Krolewski, Andrzej S., Joslin Diabetes Center, Boston, Massachusetts, United States
Background
The Joslin Kidney Panel (JKP) of 21 circulating proteins is associated with increased risk of ESKD in patients with diabetes (Kobayashi et al. KI 2022). We evaluated the JKP as a tool for assessing prognosis in Chronic Renal Insufficiency Cohort (CRIC).
Methods
We conducted a case-cohort study involving 218 participants with diabetes and impaired renal function at baseline. Using assays developed by OLINK inc. to measure JKP 21 proteins we quantified concentration of the proteins at Baseline and at follow-up (interval 2 years apart) in study groups; cases were those who progress to ESKD within 10-years (n=89), and controls were those who did not progress to ESKD within 10-years (n=129). We employed logistic regression models to determine the association of baseline concentration, longitudinal change (DELTA), and INDEX (Baseline and DELTA) for each biomarker with progression to ESKD.
Results
Higher levels of 19 of 21 proteins at baseline and 20 of 21 DELTAs and INDEXs were statistically and significantly associated with an increased risk of progression to ESKD within 10 years. Among the 20 INDEXs, 5 including TNF-R7, WFDC2, SYND1, KIM-1, and PVRL4 remained statistically significant after adjusting for GFR-INDEX and baseline 24-hour urinary protein (24h-UP).
Conclusion
Higher levels of most proteins at baseline, DELTAs, and INDEXs in JKP were significantly associated with increased ESKD risk within 10 years. INDEXs for the 5 proteins were better in prediction of risk of ESKD than GFR-INDEX. Further studies are needed to validate the utility of measuring INDEXs for prediction of ESKD and monitoring the effectiveness of reno-protective therapies.
CRIC data was provided by NIDDK CR, a program of the National Institute of Diabetes and Digestive and Kidney Diseases, and this study was supported by a grant from Renalityx Inc.
Funding
- NIDDK Support