Nephrology · Endocrinology ·
suPAR Levels Associated With Albuminuria Progression in Type 1 Diabetes
A post hoc analysis of 506 participants in the three-year PERL trial found that higher baseline suPAR was associated with faster albuminuria worsening in people with type 1 diabetes and early-to-moderate diabetic kidney disease. The association was also observed among participants who were normoalbuminuric at baseline, but the analysis does not establish causality or clinical utility for suPAR testing.
- Each suPAR doubling was linked to 11.6% greater annual AER increase.
- Association was also seen in normoalbuminuric participants.
- suPAR was not independently associated with GFR slope.
- Post hoc findings do not establish causation or clinical utility.
Researchers conducted a post hoc analysis of 506 participants in the three-year, multicenter PERL trial, all of whom had type 1 diabetes and early-to-moderate diabetic kidney disease. A single baseline measurement of soluble urokinase plasminogen activator receptor (suPAR) was assessed against longitudinal albumin excretion rate (AER) and iohexol-measured glomerular filtration rate trajectories using statistical models.
Each doubling in suPAR was associated with an additional 11.6% annual increase in AER (P<0.001). Among 125 participants who met criteria for eGFR decline, the corresponding increase was 13.1% per year; among the 101 who were normoalbuminuric, it was 11.7% per year (P=0.005 for the former group). None of these normoalbuminuric participants crossed the proteinuria threshold. suPAR was not independently associated with GFR slope; its association with lower GFR was accounted for by albuminuria level.
The findings suggest suPAR may warrant further evaluation as a marker of albuminuria risk, including before albuminuria is established. However, this was an observational post hoc analysis with only one suPAR measurement, and it does not show that suPAR causes kidney injury or that testing improves risk stratification or outcomes.
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Clinical Journal of the American Society of Nephrology: suPAR Is Associated with Progressive Albuminuria in Type 1 Diabetes ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.