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PROJECT DESCRIPTION: End stage renal
failure (ESRD) is a leading cause of death in diabetic patients.
There is also epidemiological evidence showing that Chinese diabetic
patients have increased risk of developing ESRD. In light of the
growing population of diabetic people in China, predicted to
increase from the present 18 million to 40 million in 2025, the
number of diabetic people with ESRD will also continue to rise with
its implications on health care costs, quality of life and societal
productivity. There are now proven treatment strategies with
particular emphasis on periodic monitoring, treatment to target,
adherence to therapy and use of medications to reduce the rate of
decline of renal function using a multidisciplinary approach. This
form of intensive therapy is most likely to benefit high risk
individuals in whom event rates are expected to be high. In this
respect, there is now epidemiological and scientific evidence
showing that there are genetic predispositions to the development of
diabetic kidney disease and that multiple metabolic pathways are
implicated in the process. Using cross sectional, case control and
prospective analysis, the Chinese University of Hong Kong Diabetes
Care and Research Group has confirmed the effects of a number of
polymorphism encoding the aldose reductase, angiotensin converting
enzyme, angiotensinogen, tumor necrosis factor genes and their
interactions on the progression of proteinuria, deterioration of
renal function, and development of ESRD in Chinese Type 2 diabetic
patients. We claim to use these genetic markers, but not limited to
these markers alone, along with other conventional biological
markers to assess the risk of a diabetic patient of Chinese descent
to develop kidney disease to guide management strategy with an
objective to retard the rate of deterioration of renal function and
prevent the onset of ESRD. |