A new breakthrough prognostic tool has been developed by researchers from Joslin Diabetes Center which accurately predict the risk of having end-stage renal disease (ESRD) in patients with both type 1 and type 2 diabetes.
With the use of an analytic tool called the classification and regression trees (CARTs), Dr. Krolewski and colleagues from Joslin Diabetes Center were able to determine the specific values of the two biomarkers, namely the combined circulating levels of TNFR1 and ACR, which indicated a high risk of ESRD.
They have validated these results with a group of patients with type 2 diabetes and they found out that the prognostic test for type 2 diabetes is the same with type 1.
This new finding was posted in the Kidney international website last April 7, 2017. The said test would greatly help doctors in determining the disease risk in their patients. Along with this new test is a new guide for researchers to find a cure or prevent kidney failure.
According to the National Instituter of Diabetes and Digestive and Kidney Diseases, over 660,000 Americans are affected with ESRD. 468,000 of them are in dialysis and above 193,000 have a functioning kidney transplant.
Over the years, doctors have been relying on two biomarkers - the urinary albumin to creatinine ratio (ACR) and estimated glomerular filtration rate. They have been using these tests to determine patients who have a higher risk of kidney failure as well as selecting patients for clinical trials.
However, according to researchers, these tests fail to accurately predict the time of onset ESRD. It also misses a large group of patients who are at high risk of the disease.
Kidney diseases damage the tiny filtering units of the kidney called the nephrons. A person who has diabetes can't break down glucose so they remain in the blood. High glucose levels in the blood damage the nephrons. People with hypertension and ESRD genetic history are also prone to ESRD as said by Health Line.
Medical communities believed that the progressions of ESRD in type 1 diabetes patients are different from type 2. But according to Dr. Krolewski, using the TNF receptor to analyze the risk, they have seen that the risk was identical for both type 1 and 2. This was an important observation according to him.
