Early Prediction of Diabetic Kidney Failure
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Early Prediction of Diabetic Kidney Failure

The disease among the most significant longer-term complications associated with type 2 diabetes is Diabetic Kidney failure or Diabetic Nephropathy. For the early prediction of diabetic kidney failure, urine-based biomarkers have been identified by a group of researchers from various institutions in India.

An early non-invasive marker of kidney disease and its progression is the biomarker, Microalbuminuria (MIC). For MIC to occur, it takes several years of diabetes. In early detection of diabetic kidney failure, the development of sensitive early-stage disease markers and alternative diagnostic approaches may help.

From the Department of Neurochemistry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, an Assistant Professor, Dr. Kuppan Gokulakrishnan said, “In a country where most treatment costs are paid out-of-pocket by patients, this new study is significant because the findings highlight the urgent need for search for novel therapeutic measures, effective prevention measures and need for early diagnosis.”

Symmetric and asymmetric dimethylarginines (SDMA and ADMA) are structural isomers. In patients with end-stage renal failure, altered circulatory asymmetric and symmetric dimethylarginines have been independently reported which suggests their potential role as early biomarkers of nephropathy and mediators. In urine, these alterations can be reflected.

The lead researcher

from the National Chemical Laboratory (NCL), Pune, Dr. Venkateswarlu Panchagnula said, “In every human, there are isomers found, but the isomers suddenly go out of range in nephropathy patients. The possibility of a disease is indicated by this drop. We got the diagnostic properties by looking at the ratio of these isomers.”

From more than 500 people with varying levels of glucose intolerance as well as in patients with type 2 diabetes with or without diabetic kidney disease, using Matrix-Assisted Laser Desorption/Ionization Mass Spectrometry (MALDI MS), the researchers evaluated the efficiency of Asymmetric to Symmetric dimethylarginine Ratio (ASR). The potential of it being used as an early diagnostic marker is suggested as the study found that the ASR profile is lower in MIC and macroalbuminuria (MAC). 91% of MAC and 72% of MIC respectively were correctly identified in the study.

In patients with type 2 diabetes, an insight into disease progression and timely prevention and management to reduce adverse outcomes of nephropathy is provided by this research study. As the follow-up study has to be done yet, the technology will take time to come into the market. Dr. Panchagnula told, “In the Indian context, this is the first such marker that we have reported and we are one step short to the final call.”

Scientists from the Madras Diabetes Research Foundation (MDRF), Chennai,  NIMHANS, Bangalore, and NCL, Pune are involved in this multidisciplinary collaborative research study. The journal Scientific Reports published this study’s results.

Early Prediction of Diabetic Kidney Failure – Source