A Real-World Precision Medicine Program Including the KidneyIntelX Test Effectively Changes Management Decisions and Outcomes for Patients With Early-Stage Diabetic Kidney Disease.

Link: https://doi.org/10.1177/21501319231223437
Authors: Tokita, Joji; Lam, David; Vega, Aida; Wang, Stephanie; Amoruso, Leonard; Muller, Tamara; Naik, Nidhi; Rathi, Shivani; Martin, Sharlene; Zabetian, Azadeh; Liu, Catherine; Sinfield, Catherine; McNicholas, Tony; Fleming, Fergus; Coca, Steven G; Nadkarni, Girish N; Tun, Roger; Kattan, Mike; Donovan, Michael J; Rahim, Arshad K

Abstract: The KidneyIntelX is a multiplex, bioprognostic, immunoassay consisting of 3 plasma biomarkers and clinical variables that uses machine learning to predict a patient’s risk for a progressive decline in kidney function over 5 years. We report the 1-year pre- and post-test clinical impact on care management, eGFR slope, and A1C along with engagement of population health clinical pharmacists and patient coordinators to promote a program of sustainable kidney, metabolic, and cardiac health. The KidneyIntelX in vitro prognostic test was previously validated for patients with type 2 diabetes and diabetic kidney disease (DKD) to predict kidney function decline within 5 years was introduced into the RWE study (NCT04802395) across the Health System as part of a population health chronic disease management program from [November 2020 to April 2023]. Pre- and post-test patients with a minimum of 12 months of follow-up post KidneyIntelX were assessed across all aspects of the program. Deployment and risk stratification by KidneyIntelX was associated with an escalation in action taken to optimize cardio-kidney-metabolic health including medications and specialist referrals. Glycemic control and kidney function trajectories improved post-KidneyIntelX testing, with the greatest improvements observed in those scored as high-risk.