Blood test predicts heart and kidney risk in type 2 Diabetes

Exploring cardiorenal biomarkers and canagliflozin in the CREDENCE trial.

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A groundbreaking development in healthcare has emerged, offering a potential solution for predicting future heart and kidney risks in individuals with Type 2 diabetes. Researchers have unveiled a simple blood test that promises to revolutionize early risk assessment for these critical health issues.

New research reveals that a simple blood test can help predict the risk of heart and kidney disease worsening in individuals with Type 2 diabetes and kidney disease. This study, published in the American Heart Association‘s Circulation journal, highlights the potential of specific biomarkers to indicate future health problems.

Lead author James Januzzi, M.D., who is a cardiologist at Massachusetts General Hospital and the director of heart failure and biomarker trials at the Baim Institute for Clinical Research, said, “Certain biomarkers at high levels can show heart and kidney issues and might forecast future disease risk.” The study also demonstrated that treatment with canagliflozin, a sodium-glucose co-transporter two inhibitor, can lower these biomarker levels, reducing the risk of heart failure and related complications.

Health professionals commonly use biomarkers to identify, diagnose, or manage specific conditions. Earlier research has indicated that the concentration of particular biomarkers can predict the progression of chronic kidney disease and heart problems in individuals with Type 2 diabetes.

The researchers examined blood samples from 2,627 people who participated in a study called CREDENCE. They wanted to see how a medicine called canagliflozin affects certain things in the blood that can show how the heart and kidneys are doing. They checked these things at the beginning of the study, after one year, and after three years. They also checked if these things could predict how bad the kidney problems were and the chances of dying from kidney or heart issues. They divided the patients into low, medium, and high-risk groups. People with the highest risk had more kidney and heart problems over the three years.

Here’s what they found:

  • At the start of the study, high levels of these things in the blood could tell how bad the heart and kidney problems were.
  • People who took canagliflozin had lower levels of these things in their blood after one year and three years compared to those who didn’t take it.
  • After one year, the levels of these things increased slightly in those who took canagliflozin but more in those who didn’t take it.
  • Canagliflozin helped the most in people at the highest risk of problems.
  • More research is needed to understand how Type 2 diabetes and kidney problems happen so we can help sooner before heart and kidney issues start. This could improve testing for people with Type 2 diabetes.

The study had some limitations. Not everyone in the CREDENCE trial could be included because there weren’t enough samples to test. The people who did get tested might only represent some in the study. Some data about the things they were trying changed over time, and some information needed to be included. They found good levels to predict kidney and heart problems for two things tested, but they are still figuring out the groups for the other two.

Background:

There was a trial called CREDENCE that happened from 2014 to 2018. It compared canagliflozin to a fake pill (placebo) for treating Type 2 diabetes. Canagliflozin helps the kidneys not absorb too much sugar. People in the study had Type 2 diabetes and kidney disease. The study showed that canagliflozin was better than the fake pill at reducing heart and kidney problems.

The study looked at four things in the blood to understand how the heart and kidneys were doing. These are N-terminal pro–B-type natriuretic peptide, high-sensitivity cardiac troponin T, growth differentiation factor-15, and insulin-like growth factor binding protein 7.

In conclusion, the advent of a simple blood test that can predict future heart and kidney risks in individuals with Type 2 diabetes marks a significant advancement in healthcare. This innovation has the potential to transform how these risks are identified and managed, ultimately leading to improved patient outcomes and a more proactive approach to overall health and well-being.

Journal Reference:

  1. James L. Januzzi, Reza Mohebi, et al., Cardiorenal Biomarkers, Canagliflozin, and Outcomes in Diabetic Kidney Disease: The CREDENCE Trial. Circulation. DOI: 10.1161/CIRCULATIONAHA.123.065251.