Diabetic kidney disease is a major cause of end stage renal disease and renal replacement therapy in Hong Kong, and accounts for the majority of new cases requiring dialysis. Predicting those at high risk of developing diabetic kidney disease will enable the subjects concerned and care providers to minimize other modifiable risk factors to reduce the chance of developing these life-threatening complications.
Researchers from the Department of Medicine and Therapeutics at The Chinese University of Hong Kong (CUHK) have followed-up a group of 1,172 patients with diabetes for an average period of 8 years, during which 90 had progressed to end stage renal disease. They discovered that markers within a gene called protein kinase C beta-1 (PRKCB1), can for the first time, predict those patients with diabetes who are at increased risk of developing end stage renal disease. These findings have recently been published in the prestigious medical journal, Journal of the American Medical Association.
Prof. Ronald Ma, Associate Professor of the Department of Medicine and Therapeutics, CUHK, and lead author of the paper remarked, “We know from experiments that protein kinase C beta-1 is important in the development of diabetic complications. We successfully identified several markers within the protein kinase C beta-1 gene that can predict the risk of end stage renal disease in diabetic patients. Patients with more genetic markers were more likely to develop end stage renal disease with a risk as high as 6-fold compared to those with fewer markers. These findings can have important applications on disease prevention.”
Dr Wing Yee So, Clinical Assistant Professor (honorary) of the Department of Medicine and Therapeutics, CUHK, and co-author of the paper noted, “We know from clinical studies that patients with early signs of kidney damage can reduce their risks of progression to more severe forms of kidney disease if managed under a structured intensive treatment program, with optimization of blood glucose, blood pressure and lipids, in addition to use of renoprotective medicines.”
“Identification of these genetic markers provides an excellent example of the prospect of personalized medicine in diabetes and similar diseases with multiple causes”, remarked Prof. Juliana Chan, Director of the Hong Kong Institute of Diabetes and Obesity, and senior author of the paper. “Use of genetic markers can reveal the underlying causes and help identify high risk patients for more intensive treatment. Better understanding of the interactions between genetic markers and treatment responses will also allow us to select the most appropriate treatment for the individual patient”.
The study was supported by the Hong Kong Foundation for Research and Development in Diabetes, established under the auspices of the CUHK, The Hong Kong Government Research Grant Committee, The Innovation and Technology Fund, the Research Fund of the Department of Medicine and Therapeutics and the Li Ka Shing Institute of Health Sciences, CUHK.
CUHK research group from Department of Medicine and Therapeutics discovered genetic markers to predict diabetic kidney disease in Chinese (from left) Dr Wing Yee SO, Clinical Assistant Professor (honorary); Professor Juliana Chung Ngor CHAN, Professor of Medicine and Therapeutics; and Professor Ronald Ching Wan MA, Associate Professor