PhD ceremony Mr. Alkhalaf: Novel approaches in diabetic nephropathy

PhD ceremony: Mr. Alkhalaf, 16.15 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Novel approaches in diabetic nephropathy

Promotor(s): prof. G.J. Navis, prof. H.J.G. Bilo

Faculty: Medical Sciences

In patients with type 1 diabetes, CNDP1 polymorphism predicts progression to end stage renal disease (ESRD) but not mortality. In patients with type 2 diabetes, CNDP1 polymorphism did not predict progression of decline of renal function. Cardiovascular mortality was increased in female patients with 5L-5L compared to other genotypes. These results seem to contrast with those of earlier cross-sectional studies. Large prospective studies are necessary to discern whether CNDP1 indeed plays a role as a susceptibility factor of diabetic nephropathy.

In this thesis, the role of ACE I/D polymorphism as a risk factor for development of new-onset albuminuria in patients with type 2 diabetes is confirmed. The novel polymorphism CCR2 V64I might have additional value besides ACE I/D polymorphism on predicting renal outcome. Analysis of urine proteomics by capillary electrophoresis coupled with mass spectrometry (CE-MS) is a helpful diagnostic tool for the detection of diabetic nephropathy. Recent studies showed that analysis of urinary proteomics is helpful as in detection of diabetic nephropathy at an early stage. Therefore, it is tempting to speculate that using urine proteomics allows early renoprotective treatment for those at risk to developing diabetic nephropathy, with the aim to delay or prevent development of microalbuminuria.

A 12-week treatment with benfotiamine (lipid-soluble vitamin B1) did not represent a beneficial intervention in patients with diabetic nephropathy. At this moment, there are no arguments to recommend benfotiamine to patients with diabetic nephropathy.