New Biomarker for Diabetic Kidney Disease Identified by UT Health San Antonio Researchers

The University of Texas Health Science Center at San Antonio (UT Health San Antonio) has made a groundbreaking discovery that could revolutionize the way kidney disease is diagnosed and treated in patients with diabetes. Researchers have found that urine levels of adenine, a metabolite produced in the kidney, can predict and cause progressive kidney failure in diabetic patients, even in those who do not show high levels of protein in their urine.

This finding, published in the Journal of Clinical Investigation, is significant because the current leading marker for kidney disease, protein in the urine, does not apply to all patients with diabetes. Up to half of diabetes patients who develop kidney failure do not exhibit high levels of protein in their urine. This new discovery could lead to earlier diagnosis and intervention, potentially saving lives and improving outcomes for millions of patients.

Lead researcher Kumar Sharma, MD, explained that measuring urine adenine levels could identify patients at risk of kidney failure five to ten years before it occurs. The research team also identified a therapeutic drug that can reduce kidney adenine levels in mice with type 2 diabetes, protecting against diabetic kidney disease without affecting blood sugar levels.

The study involved over 1,200 patients with diabetes from diverse populations, including African American, Hispanic, Caucasian, American Indian, and Asian participants. The results were consistent across all groups, showing that high urine adenine levels were associated with a higher risk of kidney failure.

Using a technique called spatial metabolomics on kidney biopsies, the researchers were able to map the locations of adenine and other small molecules in kidney tissues. They found that adenine was situated around scarred blood vessels and damaged kidney cells, suggesting its role in kidney injury and disease progression.

Sharma emphasized the importance of early detection and intervention in diabetic kidney disease, as patients often do not realize the severity of their condition until it is too late. By targeting adenine and kidney scarring with new therapies, the research team hopes to block kidney disease or prolong the life of the kidney in diabetic patients.

This groundbreaking research was made possible by funding from the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases. The findings have the potential to transform the way kidney disease is diagnosed and treated in patients with diabetes, offering new hope for improved outcomes and quality of life.