Urinary mRNA Signatures as Predictors of Renal Function Decline in Patients With Biopsy-Proven Diabetic Kidney Disease

Yu Ho Lee, Jung Woo Seo, Miji Kim, Donghyun Tae, Junhee Seok, Yang Gyun Kim, Sang Ho Lee, Jin Sug Kim, Hyeon Seok Hwang, Kyung Hwan Jeong, Ju Young Moon

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


The clinical manifestations of diabetic kidney disease (DKD) are more heterogeneous than those previously reported, and these observations mandate the need for the recruitment of patients with biopsy-proven DKD in biomarker research. In this study, using the public gene expression omnibus (GEO) repository, we aimed to identify urinary mRNA biomarkers that can predict histological severity and disease progression in patients with DKD in whom the diagnosis and histologic grade has been confirmed by kidney biopsy. We identified 30 DKD-specific mRNA candidates based on the analysis of the GEO datasets. Among these, there were significant alterations in the urinary levels of 17 mRNAs in patients with DKD, compared with healthy controls. Four urinary mRNAs—LYZ, C3, FKBP5, and G6PC—reflected tubulointerstitial inflammation and fibrosis in kidney biopsy and could predict rapid progression to end-stage kidney disease independently of the baseline eGFR (tertile 1 vs. tertile 3; adjusted hazard ratio of 9.68 and 95% confidence interval of 2.85–32.87, p < 0.001). In conclusion, we demonstrated that urinary mRNA signatures have a potential to indicate the pathologic status and predict adverse renal outcomes in patients with DKD.

Original languageEnglish
Article number774436
JournalFrontiers in Endocrinology
Publication statusPublished - 2021 Nov 9

Bibliographical note

Funding Information:
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2018R1D1A1B05049016 and 2021R1G1A1014115).

Publisher Copyright:
Copyright © 2021 Lee, Seo, Kim, Tae, Seok, Kim, Lee, Kim, Hwang, Jeong and Moon.


  • biomarker
  • diabetic kidney disease
  • mRNA
  • renal pathology
  • urine

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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