{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T06:18:56Z","timestamp":1783750736059,"version":"3.55.0"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Proteomics International"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"Background<\/jats:title>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.<\/jats:p><\/jats:sec>Objective<\/jats:title>This study evaluated the impact of PromarkerD, a biomarker-based blood test predicting the risk of diabetic kidney disease (DKD) and rapid renal decline.<\/jats:p><\/jats:sec>Methods<\/jats:title>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.<\/jats:p><\/jats:sec>Results<\/jats:title>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\u20133.45), prescribing SGLT2s (OR: 1.98 [1.56\u20132.52]), increasing lisinopril dose (OR: 1.48 [1.17\u20131.87]), and replacing ibuprofen (OR: 1.78 [1.32\u20132.40]). A low-risk PromarkerD result was associated with significantly lower odds of increasing monitoring frequency (OR: 0.48 [0.37\u20130.64]), prescribing SGLT2s (OR: 0.70 [0.56\u20130.88]), and replacing ibuprofen (OR: 0.75 [0.57\u20130.99]).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>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.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0271740","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T18:45:40Z","timestamp":1659379540000},"page":"e0271740","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of the clinical utility of the PromarkerD in-vitro test in predicting diabetic kidney disease and rapid renal decline through a conjoint analysis"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-2876","authenticated-orcid":true,"given":"Lauren","family":"Fusfeld","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica T.","family":"Murphy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YooJin","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li Ying","family":"Kam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten E.","family":"Peters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pearl","family":"Lin Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Shanik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Turchin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,8,1]]},"reference":[{"key":"pone.0271740.ref001","unstructured":"CDC. 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Lin","year":"2016","journal-title":"World Journal of Diabetes"},{"key":"pone.0271740.ref022","first-page":"18","article-title":"The landscape of diabetic kidney disease in the United States","author":"OK Duru","year":"2018","journal-title":"Current Diabetes Reports"},{"issue":"1","key":"pone.0271740.ref023","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12882-020-01731-x","article-title":"Barriers and enablers to detection and management of chronic kidney disease in primary healthcare: A systematic review.","volume":"21","author":"EP Neale","year":"2020","journal-title":"BMC Nephrology."},{"issue":"13","key":"pone.0271740.ref024","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1001\/jama.2019.14745","article-title":"Chronic kidney disease diagnosis and management: a review.","volume":"322","author":"TK Chen","year":"2019","journal-title":"JAMA\u2014Journal of the American Medical 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retrospective cohort study.","volume":"3","author":"G Goderis","year":"2013","journal-title":"BMJ Open."},{"issue":"5","key":"pone.0271740.ref040","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/j.1525-139X.2011.00969.x","article-title":"Standardized definitions for hemodialysis vascular access.","volume":"24","author":"T Lee","year":"2011","journal-title":"Seminars in Dialysis."},{"issue":"3","key":"pone.0271740.ref041","doi-asserted-by":"crossref","first-page":"245","DOI":"10.2337\/ds18-0033","article-title":"Diabetes management in the elderly","volume":"31","author":"E Leung","year":"2018","journal-title":"Diabetes Spectrum"},{"issue":"2","key":"pone.0271740.ref042","doi-asserted-by":"crossref","first-page":"335","DOI":"10.2215\/CJN.04650417","article-title":"Diabetic Kidney Disease","volume":"13","author":"L Tong","year":"2018","journal-title":"Clinical journal of the American Society of Nephrology"},{"issue":"1","key":"pone.0271740.ref043","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12877-018-0732-4","article-title":"Diabetic kidney disease in the elderly: prevalence and clinical correlates.","volume":"18","author":"GT Russo","year":"2018","journal-title":"BMC Geriatrics."},{"key":"pone.0271740.ref044","first-page":"47","article-title":"Experimental design, efficiency, coding, and choice designs","author":"W. 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