Genetic risk scores identify people at high risk of developing diabetic kidney disease: A systematic review.

Abstract

Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease (ESRD). Measures to prevent and treat DKD require better identification of patients most at risk. In this systematic review, we summarise the existing evidence of genetic risk scores (GRSs) and their utility for predicting DKD in people with type 1 or type 2 diabetes. We searched MEDLINE, Embase, Web of Science and Cochrane Reviews in June 2022 to identify all existing and relevant literature. Main data items sought were study design, sample size, population, single nucleotide polymorphisms (SNPs) of interest, DKD-related outcomes, and relevant summary measures of result. The Critical Appraisal Skills Programme checklist was used to evaluate the methodological quality of studies. We identified 400 citations of which 15 were included in this review. Overall, seven studies had positive results, five had mixed results and three had negative results. Most studies with the strongest methodological quality (n = 9) reported statistically significant and favourable findings of a GRS' association with at least one measure of DKD. This systematic review presents evidence of the utility of GRSs to identify people with diabetes that are at high risk of developing DKD. In practice, a robust GRS could be used at the first clinical encounter with a person living with diabetes in order to stratify their risk of complications. Further prospective research is needed.