A Potential Test of Kidney Inflammation in Adolescents with T1D

This study examined a subset of adolescents with T1D who were screened for entry into the Adolescent Type 1 Diabetes Cardio-Renal Protection (AdDIT) Study. Urine from these participants was tested for the presence of inflammatory markers. Proteins such as interleukin 6, interleukin 8, platelet-derived growth factor-AA and RANTES appear to be increased in those adolescents with higher protein levels present in urine (albuminuria), indicating a higher risk for future diabetic kidney disease. These proteins may represent early signals that can indicate individuals most likely to develop diabetic nephropathy in the future using a simple blood test.

Reference:

Urinary markers of renal inflammation in adolescents with Type 1 diabetes mellitus and normoalbuminuria. Cherney DZ, Scholey JW, Daneman D, Dunger DB, Dalton RN, Moineddin R, Mahmud F, Dekker R, Elia Y, Sochett E, Reich HN. Diabet Med. 2012 Mar 14. doi: 10.1111/j.1464-5491.2012.03651.x. [Epub ahead of print]

Ramifications for Individuals with Type 1 Diabetes:

We are currently limited in our ability to predict those with T1D who will go on to develop complications of diabetes. Clinical studies are therefore needed to understand early stages of disease that may occur before clinical signs. In diabetic kidney disease, one commonly used marker of disease is albuminuria  the presence of protein in the urine. However, the amount of protein in the urine does not always predict whether diabetic kidney disease will progress, and protein may appear in urine only after some damage has occurred to the kidney. Studies to look for other potential markers of diabetic kidney disease, for example in blood and urine of those with T1D are essential to better predict disease progression and target therapy to those who need it most.

JDRF Involvement:

JDRF is funding the AdDIT study, led by David Dunger at the University of Cambridge. Funding is also being provided through CCTN, British Heart Foundation and Diabetes UK. This study is still at an early stage but will test whether a combination of 2 drugs  an ACE inhibitor and a statin can reduce damage to the cardiovascular system and kidney in adolescents with T1D and higher risk of renal disease. As well as addressing this question, the study will give information on the onset and progression of diabetic nephropathy in this population.