In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 8 ( 2022-8-1), p. e0271740-
Abstract:
Early identification of patients at risk of developing diabetic kidney disease or rapid renal decline is imperative for appropriate patient management, but traditional methods of predicting renal decline are limited. Objective This study evaluated the impact of PromarkerD, a biomarker-based blood test predicting the risk of diabetic kidney disease (DKD) and rapid renal decline. Methods Conjoint analysis clarified the importance of PromarkerD and other patient attributes to physician decisions for type 2 diabetes patients. Forty-two patient profiles were generated, with varying levels of albuminuria, estimated glomerular filtration rate (eGFR), blood pressure, hemoglobin A1c (HbA1c), age, and PromarkerD result. A web-based survey asked each physician to make monitoring/treatment decisions about eight randomly selected profiles. Data were analyzed using multivariable logit models. Results Two hundred three primary care physicians and 197 endocrinologists completed the survey. PromarkerD result was most important for increasing the frequency of risk factor monitoring. PromarkerD was second to HbA1c in importance for deciding to prescribe sodium/glucose cotransporter-2 inhibitors (SGLT2s) with a DKD indication, second to blood pressure for increasing the dose of lisinopril, and second to eGFR for replacing ibuprofen with a non-nephrotoxic medication. Compared with no PromarkerD results, a high-risk PromarkerD result was associated with significantly higher odds of increasing monitoring frequency (odds ratio [OR]: 2.56, 95% confidence interval: 1.90–3.45), prescribing SGLT2s (OR: 1.98 [1.56–2.52] ), increasing lisinopril dose (OR: 1.48 [1.17–1.87]), and replacing ibuprofen (OR: 1.78 [1.32–2.40] ). A low-risk PromarkerD result was associated with significantly lower odds of increasing monitoring frequency (OR: 0.48 [0.37–0.64]), prescribing SGLT2s (OR: 0.70 [0.56–0.88] ), and replacing ibuprofen (OR: 0.75 [0.57–0.99]). Conclusion PromarkerD could increase adoption of renoprotective interventions in patients at high risk for renal decline and lower the likelihood of aggressive treatment in those at low risk. Further studies are needed to assess patient outcomes with PromarkerD in real-world practice.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0271740
DOI:
10.1371/journal.pone.0271740.g001
DOI:
10.1371/journal.pone.0271740.g002
DOI:
10.1371/journal.pone.0271740.g003
DOI:
10.1371/journal.pone.0271740.g004
DOI:
10.1371/journal.pone.0271740.g005
DOI:
10.1371/journal.pone.0271740.t001
DOI:
10.1371/journal.pone.0271740.t002
DOI:
10.1371/journal.pone.0271740.s001
DOI:
10.1371/journal.pone.0271740.s002
DOI:
10.1371/journal.pone.0271740.s003
DOI:
10.1371/journal.pone.0271740.s004
DOI:
10.1371/journal.pone.0271740.s005
DOI:
10.1371/journal.pone.0271740.s006
DOI:
10.1371/journal.pone.0271740.s007
DOI:
10.1371/journal.pone.0271740.s008
DOI:
10.1371/journal.pone.0271740.s009
DOI:
10.1371/journal.pone.0271740.s010
DOI:
10.1371/journal.pone.0271740.r001
DOI:
10.1371/journal.pone.0271740.r002
DOI:
10.1371/journal.pone.0271740.r003
DOI:
10.1371/journal.pone.0271740.r004
DOI:
10.1371/journal.pone.0271740.r005
DOI:
10.1371/journal.pone.0271740.r006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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