Biomarkers can serve as tools to maintain kidney health for patients with CKD
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Biomarkers can identify patients at high risk for diabetic kidney disease, as well as help nephrologists make early clinical decisions to slow its progression, according to a speaker at ASN Kidney Week.
“We need to do this because we cannot keep that status quo where people are referred at late stages, then you talk about dialysis or transplant,” Steven G. Coca, DO, MS, associate professor of medicine at Icahn School of Medicine at Mount Sinai, said during the virtual meeting. “We have the power to slow the progression in the early stages when there is not irreversible fibrosis and we can make a significant modification of the kidney disease trajectory.”
Coca said to identify high-risk patients with biomarkers and optimize clinical outcomes, nephrologists cannot “go from zero to 60 in 3 seconds.” There is currently some reluctance to use biomarkers, he said.
However, their use can help guide management of diabetic kidney disease. Additionally, risk stratification of patients with prognostic biomarkers, would help inform clinical decisions, he said.
“Low-risk, less aggressive [diabetic kidney disease], maybe say ‘OK hold onto for now.’ But as they [patients] get into medium or higher risk, there is no excuse. Use the guideline recommended therapy and try to slow progression. You really have the motivation – not only on the physician side but also the patient side – to get on a multiple drug therapy for diabetic kidney disease.”
Coca said a key tool to find and manage the high-risk patients involves integrating levels of the relevant biomarkers. He said KidneyIntel X was created as a diagnostic tool to assess patients’ risk level for progressive kidney function decline. It integrates the three strongest biomarkers – sTNFR-1, sTNFR-2 and KIM-1 with clinical variables to predict the risk of progression of diabetic kidney disease.
“It is really about maintaining kidney health and not talking about end-stage kidney disease or kidney failure,” Coca said.
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Coca SG. Application of biomarkers to diagnose patients at risk of diabetic kidney disease: Where are we? Presented at: ASN Kidney Week; Nov. 4-7, 2021 (virtual meeting).
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