Comparison of serum and urinary biomarker panels with albumin/creatinine ratio in the prediction of renal function decline in type 1 diabetes

• DOI: 10.1007/s00125-019-05081-8
• Publication Date: 2020-01-08T06:02:28Z
• Authors: Marco Colombo; Stuart J. McGurna...; Luke A. K. Blackb...; R. Neil Dalton; David Dunger; Samira Bell; John R. Petrie; Fiona Green; Sandra MacRury; John A. McKnight; John Chalmers; Andrew Collier; Paul M. McKeigue; Helen M. Colhoun
• Keywords: Albuminuria

Abstract Aims/hypothesis We examined whether candidate biomarkers in serum or urine can improve the prediction of renal disease progression type 1 diabetes beyond prior eGFR, comparing their performance with urinary albumin/creatinine ratio (ACR). Methods From population-representative Scottish Diabetes Research Network Type Bioresource (SDRNT1BIO) we sampled 50% and 25% those starting eGFR below above 75 ml min −1 [1.73 m] −2 , respectively ( N = 1629), median 5.1 years follow-up. Multiplexed ELISAs single molecule array technology were used to measure nine 13 based on our others’ work using large discovery studies. Associations final <30 [1.73] m both adjusted for baseline tested linear logistic regression models. Parsimonious biomarker panels identified a penalised Bayesian approach, was evaluated through tenfold cross-validation compared ACR other clinical record data. Results Seven seven strongly associated either adjusting covariates (all at p <2.3 × 10 −3 ). Of these, associations four independent outcomes. The strongest TNF receptor 1, kidney injury CD27 antigen, α-1-microglobulin syndecan-1. These also significant normoalbuminuric participants On top covariates, r 2 increased from 0.702 0.743 biomarkers, 0.721 alone. area under receiver operating characteristic curve 0.876 0.953 0.911 Other did not outperform ACR. Conclusions/interpretation A parsimonious panel easily measurable along creatinine may predicting diabetes, potentially obviating need testing.