The Familiality of Rapid Renal Decline in Diabetes.
Authors Frodsham SG, Yu Z, Lyons AM, Agarwal A, Pezzolesi MH, Dong L, Srinivas TR, Ying
J, Greene T, Raphael KL, Smith KR, Pezzolesi MG
Submitted By Marcus Pezzolesi on 2/5/2019
Status Published
Journal Diabetes
Year 2019
Date Published 2/1/2019
Volume : Pages 68 : 420 - 429
PubMed Reference 30425064
Abstract Sustained and rapid loss of glomerular filtration rate (GFR) is the predominant
clinical feature of diabetic kidney disease and a requisite for the development
of end-stage renal disease. Although GFR trajectories have been studied in
several cohorts with diabetes and without diabetes, whether rapid renal decline
clusters in families with diabetes has not been examined. To determine this, we
estimated GFR (eGFR) from serum creatinine measurements obtained from 15,612
patients with diabetes at the University of Utah Health Sciences Center and
established their renal function trajectories. Patients with rapid renal decline
(eGFR slope < -5 mL/min/1.73 m2/year) were then mapped to pedigrees using
extensive genealogical records from the Utah Population Database to identify
high-risk rapid renal decline pedigrees. We identified 2,127 (13.6%) rapid
decliners with a median eGFR slope of -8.0 mL/min/1.73 m2/year and 51 high-risk
pedigrees (ranging in size from 1,450 to 24,501 members) with excess clustering
of rapid renal decline. Familial analysis showed that rapid renal decline
aggregates in these families and is associated with its increased risk among
first-degree relatives. Further study of these families is necessary to
understand the magnitude of the influence of shared familial factors, including
environmental and genetic factors, on rapid renal decline in diabetes.