Biomarker test helps detect progression of kidney disease in patients with diabetes
A test that incorporates plasma biomarkers was successful in predicting kidney function decline in patients with type 2 diabetes, a speaker reported.
Researchers evaluated the clinical utility of KidneyIntelX among primary care physicians in the management of diabetic kidney disease (DKD) vs. standard clinical evaluation tools, such as albuminuria, eGFR, age and blood pressure.
“In today’s world, where comorbidities associated with diabetes are on the rise, if a simple test can enable early intervention to prevent progression of kidney disease, patients and physicians can be more confident about their treatment plans,” Manasi Datar, PhD, director at Boston Healthcare Associates, said in a presenting the study results during a late-breaking trials session at the virtual National Kidney Foundation Spring Clinicals Meeting.
The test uses an algorithm and electronic health records data to provide a risk score in patients with early-stage DKD before clinical symptoms appear, the NKF said in a press release.
“In chronic kidney disease, and particularly diabetic kidney disease, we’ve had the tools –diagnostic biomarkers and effective medications – to prevent advanced kidney disease and kidney failure, for years,” Kerry Willis, PhD, NKF chief scientific officer, said. “The challenge has been to get primary care physicians, who are seeing the majority of early-stage patients, to employ them consistently and to recognize which patients are most likely to benefit from aggressive treatment.
“KidneyIntelX has the potential to remove this critical implementation barrier, so that more patients can receive the right care at the right time,” Willis said.
Datar and colleagues used conjoint analysis to estimate preferences from 401 PCPs via a web survey. Hypothetical patient profiles were then created with the following six clinical measures: albuminuria, age, blood pressure, eGFR, HbA1c and KidneyIntelX result. Each PCP viewed eight profiles randomly selected from a fractional factorial design of 42 unique profiles.
For each patient, PCPs were asked if they would prescribe an SGLT2 inhibitor (SGLT2i), increase the dose of the angiotensin II receptor blocker (ARB) or would refer the patient to a nephrologist.
From PCPs who completed the survey, investigators found the KidneyIntelX result “was relatively more important than [standard of care] SOC tests for prescribing an SGLT2i and increasing dose of BP medications,” Datar said. “A high-risk KidneyIntelX result was associated with significantly higher odds of PCPs prescribing SGLT2i with a DKD indication, increasing ARB dose and nephrologist referral compared with no test.”
Researchers from the Icahn School of Medicine and the NKF were also involved in the study.
Datar, M. #380. Presented at: National Kidney Foundation Spring Clinical Meetings (virtual meeting); April 6-10, 2021.