#814 Inflammatory biomarkers and progression of diabetic kidney disease

Abstract Background and Aims Diabetic kidney disease (DKD) is one of the fastest growing causes of chronic kidney disease and associated morbidity and mortality. Previous studies have demonstrated the involvement of inflammation in the progression of kidney damage. The aim of our study was to evaluate potential therapeutic approaches using inflammatory biomarkers to assess DKD progression. Method A total of 499 patients with DT1 and DT2, aged 34 to 84 years (60 [60;72]), were examined. All patients underwent standard clinical and laboratory examination, with an assessment of the levels of the inflammatory biomarkers (FGF-23, TNF-α, VEGF-A, hsCRP, Il-6) in baseline plasma samples. Renal function was assessed based on the levels of serum creatinine, eGFR and albumin/creatinine ratio. Control group included 65 people the same age without diabetes. Results We divided all patients into two groups according to the presence DKD. The levels of FGF-23 (p < 0.001), TNF-α (p = 0.014), VEGF-A (p = 0.006), hsCRP (p < 0.001), Il-6 (p < 0.001) were significantly higher in patients with DKD than in control group. A predictive model was developed to estimate the probability of DKD depending on VEGF-A, FGF-23, TNF-α, Il-6, hsCRP, age, duration of diabetes, systolic blood pressure, HbA1c, LDL-C, using binary logistic regression. The resulting regression model was statistically significant (p < 0.001). Based on the value of Nagelkerke R², the model explained 79.5% of the observed DKD variance. 1 pmol/l increase of FGF-23 was associated with 1.921 times increase in DKD odds. 1 pg/ml increase of TNF-α was associated with 1.092 times decrease in DKD odds. 1 mg/ml increase of Il-6 was associated with 1.612 times increase in DKD odds. 1 mg/l increase of hsCRP was associated with 1.496 times increase in DKD odds. Conclusion Our study identifies FGF-23, TNF-α, Il-6, hsCRP as promising targets of novel therapeutic interventions in patients with diabetes, which should be investigated in future clinical trials.