JAMA Logo Patients with type 2 diabetes may succumb mostly because of renal (kidney) failure. While investigating a gene included in cell signaling, the investigators stumbled upon a novel discovery. If the scientists are to be believed, then four common variants of this gene are linked to the development of end-stage renal disease in Chinese patients with type 2 diabetes.

It is believed that Asian populations are strongly at risk of diabetic kidney disease (DKD), than white individuals. So, Asian patients may be at a higher risk of end-stage renal disease (ESRD). Protein kinase C-β (PKC-β) apparently associated to the development of diabetic complications is a molecule involved in cell signaling. In the process of the study, experts examined the variations in the PKC-β 1 gene (PRKCB1) and evaluated if they were related to the risk of new-onset ESRD.

Authors allege, “In this study of Chinese patients with type 2 diabetes followed up for 8 years, we found that genetic variants of the PRKCB1gene were associated with development of incident ESRD independent of other known risk factors, with joint effects among the risk-conferring alleles. These associations persist despite correction for retinopathy, albuminuria [the presence of excessive protein in the urine], renal function, risk factor control, and use of medications including angiotensin-converting enzyme [ACE] inhibitors at baseline.”

Ronald C. W. Ma, M.B., B.Chir. of the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China, and colleagues triggered the study on a group of Chinese patients with type 2 diabetes. The investigators initiated a genetic analysis on 1,172 Chinese patients that enrolled from1995-1998. At the beginning of the study none of the patients reported renal disease. 1,049 patients were recruited as cohorts after 1998 for validation of the results. These patients displayed an early-onset of diabetes without renal disease at baseline.

Investigators highlight, “In addition, we obtained further supporting evidence of the role of genetic variants in the PRKCBl gene in development of chronic kidney disease in an additional cohort of Chinese patients with type 2 diabetes with a comparatively shorter period of follow-up. Our consistent results thus suggest that genetic variation in the PRKCB1gene is an important determinant for the risk of developing DKD in Chinese patients with type 2 diabetes.”

The outcome of the study was that after an average of 7.9 years, 90 patients comprising 7.7 percent developed ESRD. During the analysis the investigators claimed that four common genetic variants can anticipate ESRD in separate models. This prediction was seemingly found along with the likelihood for ESRD increased with a greater number of risk alleles which is a substitute form of a gene. It was concluded that the adjusted risk for ESRD was around six times higher for patients with 4 risk alleles as compared to patients with 0 or 1 risk allele.

The study is published in the August 25 issue of JAMA.