Urine Test Predicts Diabetic Kidney Disease

Looking at various proteins in urine may help doctors predict the development of diabetic nephropathy in type 2 diabetes patients well before they develop the condition. Dr. Ravi Thadhani, from Massachusetts General Hospital and Harvard Medical School in Boston, states that, "We have identified a set of urine proteins almost 10 years before the onset of diabetic nephropathy that identify those who will go on to get diabetic nephropathy, the most common cause of renal failure in the U.S. and the world."  Diabetic nephropathy is a serious complication of diabetes in which the kidneys lose their ability to function over time.

Thadhani and colleagues compared urinary protein profiles among 62 Pima Indians with type 2 diabetes and normal kidney function who were followed for 10 years for the development of diabetic kidney disease.

The authors identified a protein "signature" that proved highly predictive of the development of diabetic nephropathy.

"While these findings require a significant amount of work to identify and test the robustness of these markers, they offer the potential for clinicians one day to be able to tell whether a diabetic patient will get renal failure well before the development of this devastating condition, and, hence, offer hope for early intervention to prevent its onset," Thadhani said.

"First we need to confirm the identification of the proteins we uncovered, then we need to test this profile in other populations with type 2 diabetes to determine if the same predictive potential remains," Thadhani explained. "Then we will carry out prospective studies in larger populations."

Diabetes Care March 2007.

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FACT:

Association between metabolic syndrome and CVD can not be explained entirely by hyperglycemia.  A Chinese study of the cardiovascular incidence relating to diabetes, pre-diabetes, and the metabolic syndrome showed that the Both hypertension and dyslipidemia, which are common in people with metabolic syndrome, are likely to play an equal or greater role in the causation of CVD. Thus, the increased CVD risk in individuals with impaired fasting glucose or diabetes was largely driven by the coexistence of multiple metabolic disorders, rather than hyperglycemia alone.  American Heart Journal,153 (552-558): Liu J, Grundy S, Wang W, Smith S Jr, Vega G, Wu Z, Zeng Z, Wang W, Zhao D Ten-year risk of cardiovascular incidence related to diabetes, prediabetes, and the metabolic syndrome