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Identification of potential biomarkers of chronic kidney disease in individuals with diabetes: protocol for a cross-sectional observational study

Lecamwasam, Ashani R, Mohebbi, Mohammadreza, Ekinci, Elif I, Dwyer, Karen M and Saffery, Richard 2020, Identification of potential biomarkers of chronic kidney disease in individuals with diabetes: protocol for a cross-sectional observational study, JMIR research protocols, vol. 9, no. 7, pp. 1-9, doi: 10.2196/16277.

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Title Identification of potential biomarkers of chronic kidney disease in individuals with diabetes: protocol for a cross-sectional observational study
Author(s) Lecamwasam, Ashani R
Mohebbi, MohammadrezaORCID iD for Mohebbi, Mohammadreza orcid.org/0000-0001-9713-7211
Ekinci, Elif I
Dwyer, Karen MORCID iD for Dwyer, Karen M orcid.org/0000-0002-4376-9720
Saffery, Richard
Journal name JMIR research protocols
Volume number 9
Issue number 7
Article ID e16277
Start page 1
End page 9
Total pages 9
Publisher JMIR Publications Inc.
Place of publication Toronto, Ont.
Publication date 2020-07
ISSN 1929-0748
1929-0748
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Public, Environmental & Occupational Health
epigenetics
metabolomics
gut microbiome
diabetes
chronic kidney disease
Summary Background The importance of identifying people with diabetes and progressive kidney dysfunction relates to the excess morbidity and mortality of this group. Rates of cardiovascular disease are much higher in people with both diabetes and kidney dysfunction than in those with only one of these conditions. By the time these people are identified in current clinical practice, proteinuria and renal dysfunction are already established, limiting the effectiveness of therapeutic interventions. The identification of an epigenetic or blood metabolite signature or gut microbiome profile may identify those with diabetes at risk of progressive chronic kidney disease, in turn providing targeted intervention to improve patient outcomes. Objective This study aims to identify potential biomarkers in people with diabetes and chronic kidney disease (CKD) associated with progressive renal injury and to distinguish between stages of chronic kidney disease. Three sources of biomarkers will be explored, including DNA methylation profiles in blood lymphocytes, the metabolomic profile of blood-derived plasma and urine, and the gut microbiome. Methods The cross-sectional study recruited 121 people with diabetes and varying stages (stages 1-5) of chronic kidney disease. Single-point data collection included blood, urine, and fecal samples in addition to clinical data such as anthropometric measurements and biochemical parameters. Additional information obtained from medical records included patient demographics, medical comorbidities, and medications. Results Data collection commenced in January 2018 and was completed in June 2018. At the time of submission, 121 patients had been recruited, and 119 samples remained after quality control. There were 83 participants in the early diabetes-associated CKD group with a mean estimated glomerular filtration rate (eGFR) of 61.2 mL/min/1.73 m2 (early CKD group consisting of stage 1, 2, and 3a CKD), and 36 participants in the late diabetic CKD group with a mean eGFR of 23.9 mL/min/1.73 m2 (late CKD group, consisting of stage 3b, 4, and 5), P<.001. We have successfully obtained DNA for methylation and microbiome analyses using the biospecimens collected via this protocol and are currently analyzing these results together with the metabolome of this cohort of individuals with diabetic CKD. Conclusions Recent advances have improved our understanding of the epigenome, metabolomics, and the influence of the gut microbiome on the incidence of diseases such as cancers, particularly those related to environmental exposures. However, there is a paucity of literature surrounding these influencers in renal disease. This study will provide insight into the fundamental understanding of the pathophysiology of CKD in individuals with diabetes, especially in novel areas such as epigenetics, metabolomics, and the kidney-gut axis. International Registered Report Identifier (IRRID) DERR1-10.2196/16277
Language eng
DOI 10.2196/16277
Indigenous content off
Field of Research 1103 Clinical Sciences
1117 Public Health and Health Services
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30141701

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.