Introduction: The Need for Precision in Diabetic Kidney Disease
Chronic kidney disease (CKD) in the context of type 2 diabetes (T2D) remains a significant global health burden. Despite the transformative impact of sodium-glucose cotransporter 2 (SGLT2) inhibitors, clinicians still face challenges in identifying which patients are at the highest risk for rapid progression and which are deriving the most benefit from therapy. Traditional markers, such as the estimated glomerular filtration rate (eGFR) and the urinary albumin-to-creatinine ratio (UACR), while foundational, often fail to capture the underlying molecular pathophysiology of kidney injury and inflammation.
This gap in prognostic and monitoring capabilities has led to the development of kidneyintelX.dkd, a biomarker-informed risk score that integrates tumor necrosis factor receptor-1 (TNFR-1), TNFR-2, and kidney injury molecule-1 (KIM-1) with clinical data. A recent analysis of the CANVAS and CREDENCE trials provides robust evidence that this score offers clinical utility far beyond traditional Kidney Disease Improving Global Outcomes (KDIGO) risk classifications.
