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Journal article
PromarkerD Versus Standard of Care Biochemical Measures for Assessing Future Renal Function Decline in Type 2 Diabetes
Diagnostics (Basel), Vol.15(6), 662
2025
PMID: 40150005
Abstract
Background/Objectives: The current standard of care for assessing chronic kidney disease complicating diabetes (DKD) includes measurement of estimated glomerular filtration rate (eGFR) and urinary albumin:creatinine ratio (uACR) but both tests have limitations. The present study compared the biomarker-based Promarker (R) D test with conventional biochemical measures for predicting future kidney function decline in adults with type 2 diabetes (T2D).
Methods: Baseline concentrations of apolipoprotein A-IV, CD5 antigen-like protein and insulin-like growth factor binding protein 3 were combined with age, serum HDL cholesterol and eGFR to generate PromarkerD risk scores for incident DKD/eGFR decline >= 30% (the primary endpoint) in 857 adults with T2D (mean age 65.4 years, 54% males). Logistic regression modelling was used to compare the association of (i) PromarkerD, (ii) eGFR, (iii) uACR, and (iv) eGFR plus uACR with this outcome during 4 years of follow-up.
Results: Study participants were classified by PromarkerD as low (63%), moderate (13%), or high risk (24%) for kidney function decline at baseline. Over a mean 4.2 years, 12.5% developed the primary endpoint. PromarkerD scores showed significantly higher predictive performance (area under the receiver operating characteristic curve (AUC) 0.88 (95% confidence interval (CI) 0.85-0.91)) compared to conventional biochemical measures (AUC = 0.63-0.82). There was a progressive increase in risk with moderate and high risk by PromarkerD exhibiting greater odds of the primary endpoint compared to those at low risk (odds ratios (OR) (95% CI) 8.11 (3.99-16.94) and 21.34 (12.03-40.54), respectively, both p < 0.001).
Conclusions: PromarkerD more accurately identifies adults with T2D at risk of kidney function decline than current usual care biochemical tests.
Details
- Title
- PromarkerD Versus Standard of Care Biochemical Measures for Assessing Future Renal Function Decline in Type 2 Diabetes
- Authors/Creators
- Kirsten E. Peters - Queen Elizabeth II Medical CentreIsabella A. Joubert - College Station Medical CenterScott D. Bringans - Queen Elizabeth II Medical CentreWendy A. Davis - The University of Western AustraliaRichard J. Lipscombe - Queen Elizabeth II Medical CentreTimothy M. E. Davis - The University of Western Australia
- Publication Details
- Diagnostics (Basel), Vol.15(6), 662
- Publisher
- MDPI
- Number of pages
- 11
- Grant note
- CAU05922 / National Health and Medical Research Council of Australia; National Health & Medical Research Council (NHMRC) of Australia National Health and Medical Research Council of Australia Practitioner Fellowship; National Health & Medical Research Council (NHMRC) of Australia 513781; 1042231 / National Health and Medical Research Council of Australia project; National Health & Medical Research Council (NHMRC) of Australia 1058260 / Federal Government of Australia under a Commercialization Australia
- Identifiers
- 991005884945407891
- Copyright
- © 2025 by the authors
- Murdoch Affiliation
- School of Medical, Molecular and Forensic Sciences
- Language
- English
- Resource Type
- Journal article
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