{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:02:45Z","timestamp":1786122165687,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>KidneyIntelX is a prognostic blood test for the progression of diabetic kidney disease (DKD) within 5\u2009years. Long\u2010term utility is important.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Adults with type 2 diabetes (T2D) and CKD (G1\u2010G3b) from two medical centres were assessed for the following: (1) baseline KidneyIntelX risk levels and their association with GDMT usage; (2) changes in temporal kidney and metabolic trajectories after testing; (3) probability for a kidney composite outcome of sustained eGFR decline of 40% or kidney failure by baseline KidneyIntelX risk strata; and (4) risk at 12\u2010month for repeat\u2010tested participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      2470 patients with T2D and CKD (median baseline eGFR 63\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      , UACR 51\u2009mg\/g, and HbA1c 7.2%), KidneyIntelX risk was 49.9% low, 40.6% intermediate, and 9.5% high. SGLT2i usage post\u2010test increased to 56%, 45%, 34% in high, intermediate, low\u2010risk groups. SGLT2i combined with GLP\u20101 increased to 32%, 25%, 17% per risk group. Improvements in eGFR slope (\u22124.6 to \u22122.6\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      \/year), UACR (relative decrease of 23%), and HbA1c (relative decrease of 7.6%) were greatest in the high\u2010risk group. Hazard ratio (HR) for DKD progression for high vs. low was 10.4 [4.4\u201324.8] and intermediate vs. low HR was 4.0 [2.0\u20138.7]. With repeat testing (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091143), 29% transitioned to lower risk accompanied by biomarker reductions, specifically KIM\u20101, and initiation of SGLT2i or GLP\u20101 doubled odds of risk reduction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>KidneyIntelX was associated with targeted GDMT usage with favourable changes in kidney and metabolic clinical measures and risk trajectories, with lower risk linked to therapy initiation and reduction in biomarkers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70993","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T02:27:26Z","timestamp":1782700046000},"page":"8428-8437","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Associations of\n                    <scp>KidneyIntelX<\/scp>\n                    Risk Stratification With Guideline\u2010Directed Therapy, Kidney Outcomes, and Metabolic Trajectories in Early Diabetic Kidney Disease"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0943-0870","authenticated-orcid":false,"given":"David","family":"Lam","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry I.","family":"Freedman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Nephrology Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joji","family":"Tokita","sequence":"additional","affiliation":[{"name":"Barbara T Murphy Division of Nephrology Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fergus","family":"Fleming","sequence":"additional","affiliation":[{"name":"Renalytix AI, PLC  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayte","family":"Suarez\u2010Farinas","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Bagwell","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Nephrology Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julienne","family":"Kirk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Nephrology Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazel","family":"Tapp","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Nephrology Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Shade","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Nephrology Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Vega","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Sinfield","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0928-9168","authenticated-orcid":false,"given":"Steven G.","family":"Coca","sequence":"additional","affiliation":[{"name":"Barbara T Murphy Division of Nephrology Icahn School of Medicine at Mount Sinai  New York New York USA"},{"name":"Renalytix AI, PLC  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6319-4314","authenticated-orcid":false,"given":"Girish N.","family":"Nadkarni","sequence":"additional","affiliation":[{"name":"Barbara T Murphy Division of Nephrology Icahn School of Medicine at Mount Sinai  New York New York USA"},{"name":"Renalytix AI, PLC  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Donovan","sequence":"additional","affiliation":[{"name":"Renalytix AI, PLC  New York New York 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