{"id":"df5a08bb393b","type":"article","url":"https://hartvaat.nl/2026/02/27/deep-endotypering-onthult-heterogeniteit-van-nierschade-bij-diabetes-type-2/","title":"Deep endotypering onthult heterogeniteit van nierschade bij diabetes type 2","title_en":"","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","internist"],"tags":[],"journal":"Kidney International","doi":"https://www.kidney-international.org/article/S0085-2538(26)00143-2/fulltext","source_url":"https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00143-2/fulltext","authors":["Loreto Gesualdo","Matthias Kretzler","Paola Pontrelli"],"significance":6,"published":"2026-03-27","source_date":"2026-02-27","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/cardiometabool/diabetes-type-1-en-hart/"],"congress":"","summary_en":"Kidney damage in type 2 diabetes is highly heterogeneous and poorly captured by traditional markers such as albuminuria and eGFR. This Kidney International review discusses how deep endotyping — integrating clinical trajectory analysis, renal histopathology, and molecular profiling — can identify subgroups with distinct pathophysiology, enabling more targeted therapy selection.","created":"2026-07-03T10:32:38Z","updated":"2026-07-03T13:31:35Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Nierschade bij type 2 diabetes kent een enorme heterogeniteit die niet wordt gevangen door traditionele markers als albuminurie en eGFR. Deze review in Kidney International bespreekt hoe 'deep endotyping' — de integratie van klinische trajectanalyse, nierhistopathologie en moleculaire profilering — subgroepen kan identificeren met uiteenlopende pathofysiologie. Deze benadering kan leiden tot meer gerichte therapiekeuze en betere risicostratificatie bij diabetische nefropathie.","abstract_original":"Kidney damage in type 2 diabetes exemplifies a complex, multisystemic disorder with substantial heterogeneity in clinical trajectory, histopathology, and molecular drivers. Traditional clinical markers, albuminuria and glomerular filtration rate, fail to capture this diversity because many patients follow atypical trajectories such as nonalbuminuric progression, rapid estimated glomerular filtration rate decline, or regression of albuminuria. Deep endotyping approaches integrating clinical dynamics, renal histopathology, and multi-omics profiling can define biologically distinct endotypes."}