Plasma proteomics classifiers improve risk prediction for renal disease in patients with hypertension or type 2 diabetes

摘要: OBJECTIVE: Micro and macroalbuminuria are strong risk factors for progression of nephropathy in patients with hypertension or type 2 diabetes. Early detection to micro may facilitate prevention treatment renal diseases. We aimed develop plasma proteomics classifiers predict the development METHODS: Patients (n = 125) diabetes (n = 82) were selected this case-control study from Prevention REnal Vascular ENd-stage Disease cohort Steno Diabetes Center. Cases transitioned normo microalbuminuria, macroalbuminuria. Controls, matched age, sex, baseline albuminuria stage, did not transition. Follow-up was 3.0 ± 0.9 years. Plasma profiles measured by liquid chromatography-electrospray-trap mass-spectrometry. Classifiers developed cross-validated prediction transition stage. Improvement tested on top a reference model albuminuria, estimated glomerular filtration rate, renin-angiotensin-aldosterone system intervention. RESULTS: In hypertensive patients, classifier improved stage (C-index 0.69 0.78; P < 0.01). diabetes, 0.73 0.80; P = 0.04). both diseases, identified peptides linked pathways recognized contribute nephropathy, including fibrosis, inflammation, angiogenesis, mineral metabolism. CONCLUSIONS: beyond established markers External validation is needed assess reproducibility.