Novel Serum and Urinary Biomarkers of Diabetic Kidney Disease


Type 2 diabetes is a major public health problem worldwide. Progressive chronic kidney disease (CKD) in type 2 diabetes is associated with significant morbidity and mortality. There are few approaches available for the early detection of CKD in diabetes. The primary goal of this project is to develop novel urine biomarkers to better predict progressive CKD in diabetics. We propose that there are better markers to predict CKD in diabetics than albuminuria alone. These include biomarkers that reflect tubulointerstitial injury, inflammation and fibrosis, and oxidative stress. We have identified several promising serum and urinary biomarkers that reflect these different pathways of injury in diabetic kidney disease.

The ACCORD trial demonstrated that intensive glycemic control vs. standard glycemic control over a period of 3.5 years reduced the incidence of albuminuria but did not reduce incident CKD nor end-stage renal disease (2.1% vs. 2.2%) between the two glycemia-treatment arms. These findings require explanation and only underscore the necessity to predict incident and progressive CKD in type 2 diabetes. By analyzing the blood and urine samples collected and stored in the ACCORD study for biomarkers of kidney injury, we have two major goals in this proposal: 1) to identify biomarkers for primary prevention of incident diabetic kidney disease and for secondary prevention of progressive kidney disease; and 2) to better understand the renal outcomes of the ACCORD in relation to the applied interventions. The ultimate goal is to identify better surrogates or therapeutic targets for kidney disease in diabetics.

Bio Profile

Steven Coca, DO, MS

Principal Investigator

Assistant Adjunct Professor, Internal Medicine, Nephrology

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Bio Profile

Chirag Parikh, MD, PhD, FACP

Professor Adjunct

Director, Program of Applied Translational Research

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Tulane University 

Vivian Fonseca, MD

University of Arkansas 

Sudhir Shah, MD

Case Western University  

Faramarz Ismail-Beigi, MD

Mike Simonson, MD

University of Cincinnati  

Prasad Devarajan, MD

University of Washington  

Santica Marcovina, PhD

Wake Forest University  

Bob Byinton, MD

Tim Craven, PhD

Diabetic Kidney Disease

Contact Information

For more information, or if you are interested in collaborating on this study, please contact Steven G. Coca

Project Funding

Funding for this project comes, in part, from the following grant:

R01 DK096549 (NIH-NIDDK)

"Novel serum and urinary biomarkers of diabetic kidney disease"

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