New biomarkers may accurately identify renal disease in patients with type 2 diabetes

A new study has identified three blood biomarkers of advanced renal dysfunction and chronic kidney disease (CKD) in people with type 2 diabetes.
The new markers, which associate with the intensity of kidney disease, are plasma apolipoprotein A-IV (apoA4), CD5 antigen-like (CD5L), and complement C1q subcomponent subunit B (C1QB).
According to the findings, published in the Diabetes Care journal, they can help detect a rapidly declining renal function even independently of other known risk factors in type 2 diabetes.
Risk factors accounting for a rapid decline in renal function in patients with type 2 diabetes include poor blood glucose control, dyslipidemia and/or an unhealthy lifestyle.
A rapid renal function decline, in general, is defined by a decrease in what’s known as the estimated glomerular filtration rate (eGFR), which the new biomarkers reflect.
Researchers from the University of Western Australia, in Perth, tested the validity of the biomarkers using data on 345 participants from the Fremantle Diabetes Study Phase II.
The study team assessed the progression of CKD in participants by using the average annual decline in eGFR.
Some studies suggest that a decline rate in eGFR of over 3 ml/min/1.73 m2 per year indicates rapid CKD progression.
Here, researchers have found that ten per cent of participants showed signs of moderately rapid CKD progression based on a mean annual decrease in the eGFR of 2.9 mL/min/1.73 m2 per year.
Changes in the biomarkers ApoA4, CD5L and C1QB all correlated with a decline in eGFR. For example, high concentrations of ApoA4 were associated with a 2.4-fold increased risk of rapid eGFR decline and CKD progression.
Further research will aim to identify genes which genetically determine ApoA4 blood concentrations as well as the levels of other biomarkers using genome-wide association studies.
Overall, this study suggests that ApoA4, CD5L and C1QB could serve as early markers of renal impairment in people with type 2 diabetes.