A simple blood test might reveal which people with diabetes are most prone to kidney failure, two long-term studies show. Both studies linked high levels of proteins called tumor necrosis factor, or TNF, receptors with elevated incidence of kidney disease up to 12 years later. The association showed up in patients with type 1 and type 2 diabetes, the researchers report online January 19 in the Journal of the American Society of Nephrology.
Study leader Andrzej Krolewski, a kidney researcher at Harvard Medical School and the Joslin Diabetes Center in Boston, says the findings may ultimately improve care for at-risk diabetes patients. "The most immediate application," says study coauthor Monika Niewczas, a researcher also at Harvard and Joslin, "will be a diagnostic test that we hope would be available soon."
TNF receptors serve as docking stations on cells. When their counterpart protein latches onto the receptor, the signal produced by that binding can instruct a cell to trigger inflammation or to take on other duties. Some TNF receptors also roam free, showing up in the blood, a characteristic the scientists measured in the new studies.
"These are good pilot studies, very well conducted," says Sankar Navaneethan, a nephrologist at the Cleveland Clinic who wasn't involved in the new research. "But they need to be replicated in future studies before we can embark on using this biomarker for predicting these outcomes in patients."
In one study, the researchers tracked the health status of 410 people with type 2 diabetes beginning in the early …