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Evaluating the potential clinical practice impact of the PromarkerD blood test in people with type 2 diabetes in Australia

Lianzhi K. Chen, Isabella A. Joubert, Li Ying Kam, Kirsten E. Peters, Pearl Lin Tan, Merlin C. Thomas

Abstract

Background

Chronic kidney disease (CKD) is a frequent complication of type 2 diabetes (T2D). Early treatment can prevent kidney damage, reduce mortality and hospitalisations and delay progression to end-stage kidney disease. While albuminuria screening identifies some at-risk individuals, additional tools are needed to stratify risk in those with normal or moderately increased albuminuria and enable timely use of renoprotective therapies.

Aims

This study evaluated the potential impact of PromarkerD, a biomarker-based blood test that predicts CKD risk, on T2D management by Australian clinicians.

Methods

A web-based survey was conducted among general practitioners, endocrinologists, nephrologists and diabetologists to understand current management of patients with T2D and early-stage CKD (estimated glomerular fitration rate ≥60 mL/min per 1.73 m2 and normal or moderately increased albuminuria). Clinicians assessed the utility of a validated predictive CKD test and its influence on treatment decisions. The survey introduced the clinical evidence supporting PromarkerD but blinded respondents to the test's commercial name to reduce bias.

Results

Responses from 178 clinicians revealed an unmet need for predictive CKD testing in T2D management. PromarkerD testing was associated with earlier treatment initiation in moderate- and high-risk individuals. Among high-risk patients, clinicians reported increased prescribing of sodium-glucose co-transporter 2 inhibitors (62% vs. 40%), angiotensin-converting enzyme inhibitors (73% vs. 49%), angiotensin receptor blockers (66% vs. 42%) and statins (57% vs. 32%), compared with standard care (all P < 0.0001). Moderate-risk individuals also saw smaller but significant increases (all P ≤ 0.007).

Conclusions

Predictive PromarkerD risk scores could improve CKD prevention in T2D by enabling early intervention and guided treatment strategies, with the potential to improve patient outcomes.

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