Nonproteinuric progressive diabetic kidney disease

Area of Science:

• Nephrology
• Endocrinology
• Diabetology

Background:

• Diabetic kidney disease (DKD) can develop in patients without proteinuria, including those with type 1 diabetes.
• The progression to kidney failure is slower in nonproteinuric patients compared to proteinuric ones.
• Early identification of DKD risk in nonproteinuric individuals is crucial.

Purpose of the Study:

• To review epidemiological data on DKD risk in nonproteinuric patients.
• To highlight novel research utilizing proteomic biomarkers for DKD prediction.
• To discuss the potential of SGLT2 inhibitors in preventing DKD progression in this population.

Main Methods:

• Review of recent epidemiological studies on nonproteinuric DKD.
• Focus on research employing proteomic biomarkers for DKD risk assessment.
• Analysis of clinical trial data and observational studies on SGLT2 inhibitors.

Main Results:

• The CKD273 proteomic biomarker effectively predicts the risk of microalbuminuria, macroalbuminuria, and CKD in nonalbuminuric diabetic individuals.
• Sodium-glucose transporter 2 (SGLT2) inhibitors demonstrate a significant reduction in albuminuria across various patient groups.
• SGLT2 inhibitors may also decrease albumin excretion in patients with normal albuminuria levels.

Conclusions:

• CKD273 is a promising biomarker for early identification of nonproteinuric patients at high risk for progressive DKD.
• SGLT2 inhibitors, such as empagliflozin, show potential in mitigating DKD progression in nonalbuminuric diabetic patients.
• Further clinical trials are needed to confirm the efficacy of SGLT2 inhibitors in preventing DKD progression in nonalbuminuric populations.