Gene variants put diabetics at risk of kidney disease

HONG KONG (Reuters) - Some diabetics are at risk of developing chronic kidney disease if they have mutations in a certain gene, a long-term study in Hong Kong has found.

Kidney failure is an important cause of death for people with type 2 diabetes, and ethnic Chinese diabetics are more prone to developing chronic kidney disease than Caucasians.

The finding would help identify diabetes patients prone to developing kidney disease so they could be rigorously monitored and given more intensive preventive treatment, wrote the lead researcher in reply to questions from Reuters.

"Identification of those genetically at risk of developing renal complications can help identify these subjects for intensive management, and also may help to motivate individuals to be more compliant to treatment," wrote Ronald Ma of the Chinese University and Prince of Wales Hospital in Hong Kong.

In a paper published in the Journal of the American Medical Association on Wednesday, Ma and colleagues said they tracked for nine years 1,172 diabetes patients in Hong Kong who were free of kidney disease at the start of the study.

By the end of the eight-year study period, 90 of them had developed kidney disease.

The researchers analysed the DNA of all the participants and found that four mutations of a particular gene - PRKCB1 - occurred far more frequently in the group with kidney disease.

"The risk for end-stage renal disease was approximately six times higher for patients with 4 risk alleles (mutations) compared with patients with 0 or 1 risk allele," they said.

The same findings were confirmed in another group of 1,049 diabetes patients.

Type 2 diabetes is caused by the body's inability to adequately use insulin, a hormone produced by the pancreas, to control glucose sugar produced from food. Sugar levels rise and can damage the eyes, kidneys, nerves, heart and major arteries.

Diabetes is exploding in China due to changes in diet, a sedentary lifestyle, smoking and a worsening obesity problem. China has 94 million diabetic adults and another estimated 148.2 million Chinese are living with prediabetes.

SOURCE: http://link.reuters.com/qym27n JAMA/Journal of the American Medical Association, August 25, 2010.