New Gene Regions Linked to Diabetic Kidney Disease in Type 1

I t’s well known that having poorly controlled or longstanding diabetes increases the risk of developing complications, including diabetic kidney disease (DKD)—a leading cause of disability in people with diabetes that can end in organ failure. That’s because elevated blood glucose levels cause damage to blood vessels over time, and the tiny blood vessels in your kidneys are especially prone to this type of damage.

But blood glucose control and duration of diabetes aren’t the only factors in developing diabetic kidney disease. In a new study—the largest ever to look at the genetic factors behind this complication—researchers at University College Dublin (UCD) in Ireland have identified 16 areas of the human genome that contribute to diabetic kidney disease risk in people with type 1 diabetes. Scientists have long known that there are wide individual differences in who develops diabetic kidney disease, since some people with excellent blood glucose control will eventually develop it, while others with less-ideal control won’t.

So researchers at UCD, in cooperation with teams at other universities in Europe and North America, looked at 19,406 people with type 1 diabetes—with and without kidney disease—to try to find out what genetic factors might help explain differences in risk. As described in a UCD press release, participants received kidney function tests and urine tests to look for indicators of kidney disease.

They also had their genomes scanned, and researchers looked for links between gene regions and kidney-related outcomes. Out of the 16 areas of the human genome that the researchers identified as related to diabetic kidney disease, the strongest link was found in a gene variant that affects the structure of certain membranes in your kidneys by making a form of collagen, a protein. Other identified gene regions were also associated with collagen production or with inflammation or immunity.

The researchers hope that identifying these gene regions is the first step toward developing therapies to protect vulnerable people from diabetic kidney disease. “Despite our best efforts, the rates of diabetes and associated vascular complications remain unacceptably high,” says lead researcher Catherine Godson, a professor at the UCD School of Medicine, in the press release. “There is an urgent need to predict those individuals with diabetes who are at risk of developing complications such as DKD and to develop effective drugs to treat the disease in susceptible people.” DSM