NOVEL BIOMARKERS AND PREDICTION OF KIDNEY DISEASE PROGRESSION IN AUSTRALIAN FIRST NATION PEOPLE WITH AND WITHOUT DIABETES: THE eGFR STUDY

E-Poster

https://storage.unitedwebnetwork.com/files/1099/710793a92bb11c4dc98faa12b2f63977.pdf

Abstract Title

First Name *

Richard

Last Name *

MacIsaac

Co-author 1

Elizabeth Barr elizabeth.barr@menzies.edu.au Charles Darwin University Menzies School of Health Research Darwin Australia

Co-author 2

Federica Barzi frederica.bazi@menzies.edu.au Charles Darwin University Menzies School of Health Research Darwin Australia

Co-author 3

Phillip Mills phillipmills4875@gmail.com James Cook University Australian Institute of Tropical Health and Medicine Cairns Australia

Co-author 4

Maria Nickels maria.nickels@menzies.edu.au Charles Darwin University Menzies School of Health Research Darwin Australia

Co-author 5

Sian Graham sian.graham@menzies.edu.au Charles Darwin University Menzies School of Health Research Darwin Australia

Co-author 6

Varuni Obeyesekere varuni.obeyesekere@svha.org.au St Vincent's Hospital Melbourne Endocrinology Fitzory Australia

Co-author 7

Wendy Hoy w.hoy@uq.edu.au University of Queensland Nephrology Brisbane Australia

Co-author 8

Graham Jones graham.jones@svha.org.au St Vincent's Hospital SydPath Sydney Australia

Co-author 9

Paul Lawton paul.lawton@menzies.edu.au Charles Darwin University Menzies School of Health Research Darwin Australia

Co-author 10

Alex Brown Alex.Brown@telethonkids.org.au South Australian Health and Medical Research Institute Aboriginal Health Equity Adelaide Australia

Co-author 11

Mark Thomas Mark.Thomas@health.wa.gov.au Royal Perth Hospital Nephrology Perth Australia

Co-author 12

Ashim Sinha ashim.sinha@health.qld.gov.au Cairns Base Hospital Diabetes & Endocrinology Cairns Australia

Co-author 13

Alan Cass alan.cass@menzies.edu.au Charles Darwin University Menzies School of Health Research Darwin Australia

Co-author 14

Jaquelyne Hughes jaqui.hughes@flinders.edu.au Flinders University Rural and Remote Health Darwin Australia

Co-author 15

Louise Maple-Brown louise.maple-brown@menzies.edu.au Charles Darwin University Menzies School of Health Research Darwin Australia

Introduction

Chronic kidney disease (CKD) and diabetes have significant health and well-being impacts on Australian Aboriginal and Torres Strait Islander populations. Although routine clinical tests modestly predict CKD progression, assessment of other biomarkers is warranted as there is an increasing appreciation that myocardial and renal microvascular disease driven by subclinical inflammation may be the link that explains the tight relation between dysfunction in the heart and kidney. Few studies have assessed novel biomarkers concurrently in populations with and without diabetes, which is vital to determining risk factor correlations. This study investigates the relationships of cardio-metabolic and inflammatory biomarkers with the decline in estimated glomerular filtration rate (eGFR) among Australia’s First Nations People, with and without diabetes.

Methods

The prospective eGFR study cohort recruited participants according to diabetes and/or kidney function strata. Multivariable linear regression estimated change in 2009 CKD-Epi eGFR creatinine-based formula (ml/min/1.73m²/year) according to baseline plasma kidney injury molecule-1 (pKIM-1) (pg/ml), soluble tumour necrosis factor receptor-1 (sTNFR-1) (pg/ml), high-sensitivity troponin-T (hs-TnT) (ng/L) and troponin-I (hs-TnI) (ng/L) after adjusting for baseline factors.

Results

Over three years, individuals with diabetes (n=155), but not those without diabetes (n=232), exhibited a greater eGFR decline for higher levels of pKIM-1 (-1.5 [95% CI: -3.2 to 0.1], p=0.07), sTNFR-1 (-3.6 [-6.7 to -0.4], p=0.03), hs-TnT >5.4ng/L (-3.6 [-6.9 to -0.2], p=0.04) and hs-TnT >10.0ng/L (-6.1 [-9.8 to -2.4], p=0.001) compared to hs-TnT ≤3.0ng/L, after adjusting for eGFR, urinary albumin-to-creatinine ratio (uACR), age, sex and biomarker levels. Baseline age, sex, eGFR, and uACR explained 14% of the variance in eGFR decline, and adding pKIM-1, hs-TnT, and sTNFR-1 increased this to 24% (p=0.002). Associations remained after adjustment for several clinical covariables or using the 2021 CKD-Epi eGFR creatinine-based formula. hs-TnI showed no significant association with eGFR decline in individuals with or without diabetes.

Conclusions

This study suggests that cardio-metabolic and inflammatory biomarkers may improve prediction of kidney disease progression among Australian first nation people with diabetes.

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