scholarly journals Urinary Neutrophil Gelatinase-Associated Lipocalin Is Complementary to Albuminuria in Diagnosis of Early-Stage Diabetic Kidney Disease in Type 2 Diabetes

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Agnieszka Gala-Błądzińska ◽  
Paulina Dumnicka ◽  
Beata Kuśnierz-Cabala ◽  
Katarzyna Rybak ◽  
Ryszard Drożdż ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Early Stage ◽  
Control Group ◽  
Tubular Damage ◽  
Diabetic Kidney ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Background. Two clinical phenotypes of diabetic kidney disease (DKD) have been reported, that is, with or without increased albuminuria. The aim of study was to assess the usefulness of urinary neutrophil gelatinase-associated lipocalin (uNGAL) for the early diagnosis of DKD in the type 2 diabetes mellitus (T2DM). Methods. The study group consisted of 123 patients with T2DM (mean age 62 ± 14 years), with urine albumin/creatinine ratio (uACR) < 300 mg/g and eGFR ≥ 60 ml/min/1.73 m2. The control group included 22 nondiabetic patients with comparable age, sex, and comorbidities. uNGAL, albumin, and creatinine were measured in the first morning urine samples. uACR and uNGAL/creatinine ratios (uNCR) were calculated. Results. In the control group, maximum uNCR was 39.64 µg/g. In T2DM group, 24 patients (20%) had higher results, with the maximum value of 378.6 µg/g. Among patients with uNCR > 39.64 µg/g, 13 (54%) did not have markedly increased albuminuria. Women with T2DM had higher uNCR than men (p<0.001), without difference in uACR (p=0.09). uNCR in T2DM patients correlated significantly with HbA1c. Sex, total cholesterol, and uACR were independent predictors of uNCR above 39.64 µg/g. Conclusions. Increased uNGAL and uNCR may indicate early tubular damage, associated with dyslipidemia and worse diabetes control, especially in females with T2DM.

scholarly journals Neutrophil Gelatinase-Associated Lipocalin and Retinol-Binding Protein-4 as Biomarkers for Diabetic Kidney Disease

2020 ◽  
Vol 45 (2) ◽  
pp. 222-232 ◽  
Author(s):  
Fatemeh Abbasi ◽  
Fatemeh Moosaie ◽  
Pegah Khaloo ◽  
Fatemeh Dehghani Firouzabadi ◽  
Seyede Marzie Fatemi Abhari ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Binding Protein ◽  
Retinol Binding Protein ◽  
Control Group ◽  
Tubular Damage ◽  
Retinol Binding Protein 4 ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Aims: This study was designed to evaluate the conflicting association between 2 tubular protein markers including neutrophil gelatinase-associated lipocalin (NGAL) and retinol-binding protein-4 (RBP-4) with albuminuria and glomerular filtration rate (GFR) and calculate the accuracy of the role of NGAL and RBP-4 in diagnosis of diabetic nephropathy (DN) in patients with type2 diabetes. Methods: This is a cross-sectional study that included 133 patients with type 2 diabetes. There were 3 diabetic study groups with normoalbuminuria, moderately increased albuminuria, severely increased albuminuria, and non-diabetic control group without any renal disease. We analyzed the difference of urinary NGAL (uNGAL) and RBP-4 between nondiabetics and diabetics, as well as within the diabetic group. We also assessed the association between albuminuria and NGAL and RBP-4. Results: The urinary levels of NGAL and RBP-4 were higher in patients with type 2 diabetes compared to nondiabetics as well as in albuminuric diabetics compared to nonalbuminuric patients with diabetes (p value <0.001). These 2 proteins were higher in patients with severely increased albuminuria compared to patients with moderately increased albuminuria, even after adjustment for other metabolic factors (all p < 0.01). Moreover, areas under the curve of NGAL and RBP-4 for the diagnosis of chronic kidney disease were 80.6 and 74.6%, respectively. Conclusion: uNGAL and RBP-4 are potential markers of tubular damage that may increase before the onset of glomerular markers such as albuminuria and GFR in patients with type 2 diabetes. Therefore, these markers can be used as complementary measurements to albuminuria and GFR in the earlier diagnosis of DN.

scholarly journals Fetuin-A gene polymorphism and its serum level association with atherosclerotic vascular disease in type 2 diabetes patients with early diabetic kidney disease

2020 ◽  
Vol 7 (11) ◽  
pp. 4122-4131
Author(s):  
Eman Y. Morsy ◽  
Neveen L. Saad ◽  
Hesham A. Elghoneimy ◽  
Abd Alhalim G. Smeid ◽  
Azza A. Ismail
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Control Group ◽  
Atherosclerotic Vascular Disease ◽  
Fetuin A ◽  
Diabetic Kidney ◽  
Increased Risk

Background: The incidence of type 2 diabetes mellitus (T2DM) is increasing over the past years. Early identification and management of its complications, especially diabetic kidney disease (DKD), is of great importance. Multiple factors play a role in the pathogenesis of T2DM and DKD. We aimed to study Fetuin-A gene polymorphisms and Fetuin-A serum levels in T2DM patients with early DKD. Methods: The present work was conducted on 120 patients with T2DM (60 patients with microalbuminuria and 60 without albuminuria), and 30 healthy subjects (as a control group). Serum Fetuin-A levels were measured with ELISA. Fetuin-A, Thr256Ser and Thr248Met polymorphisms were determined by PCR-RFLP. Results: Patients with T2DM had a significantly higher mean serum Fetuin-A compared to controls (p < 0.001), while no difference was observed when comparing mean serum Fetuin-A in patients with microalbuminuria and patients without albuminuria (p = 0.916). Multivariate regression analysis demonstrated that carotid intima-media thickness (CIMT) and insulin resistance had positive correlations with serum Fetuin-A (p < 0.001 and p < 0.001, respectively). Ankle-brachial pressure index (ABPI) had a negative correlation with serum Fetuin-A (p=0.046), while Fetuin-A levels neither affected eGFR nor albuminuria. The distribution of the alleles of both polymorphisms showed increased frequency of TT (rs248) and GG (rs256) in patients without albuminuria compared to patients with microalbuminuria. Conclusion: Increased serum Fetuin-A is associated with insulin resistance and increased risk of atherosclerosis in patients with T2DM, but is not associated with the development of DKD. TT (rs248) and GG (rs256) polymorphisms may be associated with lower risk of DKD.

scholarly journals Is Urinary NGAL Determination Useful for Monitoring Kidney Function and Assessment of Cardiovascular Disease? A 12-Month Observation of Patients with Type 2 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Agnieszka Żyłka ◽  
Agnieszka Gala-Błądzińska ◽  
Paulina Dumnicka ◽  
Piotr Ceranowicz ◽  
Marek Kuźniewski ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Function ◽  
Diabetic Kidney Disease ◽  
Cardiovascular Complications ◽  
Tubular Damage ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Urine Albumin ◽  
One Year ◽  
Neutrophil Gelatinase

Background. Diabetic kidney disease (DKD) may start as glomerular or tubular damage. We assessed kidney function during one-year-long observation of patients with type 2 diabetes mellitus (T2DM) after initiation of nephroprotective treatment, with emphasis on the changes in urinary neutrophil gelatinase-associated lipocalin (uNGAL), and evaluated the association between tubular damage and cardiovascular complications of T2DM.Materials and Methods. Adult T2DM patients (55) were assessed initially and 30 patients after 1 year. Albumin and uNGAL and creatinine were measured in first morning urine. Albumin/creatinine (uACR) and uNGAL/creatinine (uNCR) ratios were calculated.Results. In logistic regression, both uACR above 30 mg/g and uNCR the median (21.3 μg/g) were associated with cardiovascular complications, independently of classical risk factors and diabetes duration. One year after initiation of treatment, a significant reduction inHbA1cwas observed. BMI and lipid profiles did not change. Increase in serum creatinine and reduction in eGFR occurred, along with decrease in uNGAL and uNCR. Increasing uNCR and uACR were associated with higher controlHbA1c. The increase in uNCR was more frequent in patients with hypertension.Conclusions. Better glycemic control in T2DM patients results in improved tubular function, as reflected by reduced uNCR and uNGAL. First morning urine uNGAL and uNCR may be useful to assess renal function and cardiovascular risk, along with albuminuria and eGFR.

scholarly journals Exenatide and Renal Outcomes in Patients with Type 2 Diabetes and Diabetic Kidney Disease

2020 ◽  
Vol 51 (10) ◽  
pp. 806-814 ◽  
Author(s):  
Xiangyu Wang ◽  
Huijie Zhang ◽  
Qian Zhang ◽  
Meiping Guan ◽  
Shuyue Sheng ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Insulin Glargine ◽  
Diabetic Kidney Disease ◽  
Intervention Group ◽  
Percentage Change ◽  
Control Group ◽  
Diabetic Kidney ◽  
Renal Outcomes

<b><i>Background:</i></b> Cardiovascular outcomes in clinical trials with type 2 diabetes mellitus (T2DM) patients have shown that glucagon-like peptide-1 receptor agonist can have a beneficial effect on the kidney. This trial aimed to assess the effects of exenatide on renal outcomes in patients with T2DM and diabetic kidney disease (DKD). <b><i>Methods:</i></b> We performed a randomized parallel study encompassing 4 general hospitals. T2DM patients with an estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m<sup>2</sup> and macroalbuminuria, defined as 24-h urinary albumin excretion rate (UAER) &#x3e;0.3 g/24 h were randomized 1:1 to receive exenatide twice daily plus insulin glargine (intervention group) or insulin lispro plus glargine (control group) for 24 weeks. The primary outcome was the UAER percentage change from the baseline after 24 weeks of intervention. The rates of hypoglycemia, adverse events (AEs), and change in eGFR during the follow-up were measured as safety outcomes. <b><i>Results:</i></b> Between March 2016 and April 2019, 92 patients were randomized and took at least 1 dose of the study drug. The mean age of the participants was 56 years. At baseline, the median UAER was 1,512.0 mg/24 h and mean eGFR was 70.4 mL/min/1.73 m<sup>2</sup>. After 24 weeks of treatment, the UAER percentage change was significantly lower in the intervention group than in the control group (<i>p</i> = 0.0255). Moreover, the body weight declined by 1.3 kg in the intervention group (the difference between the 2 groups was 2.7 kg, <i>p</i> = 0.0001). Compared to the control group, a lower frequency of hypoglycemia and more gastrointestinal AEs were observed in the intervention group. <b><i>Conclusion:</i></b> Exenatide plus insulin glargine treatment for 24 weeks resulted in a reduction of albuminuria in T2DM patients with DKD.

Albuminuria Is More Closely Associated with Vascular Endothelial Function than eGFR in Type 2 Diabetes with Diabetic Kidney Disease

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 443-P
Author(s):  
YOSHINORI KAKUTANI ◽  
MASANORI EMOTO ◽  
YUKO YAMAZAKI ◽  
KOKA MOTOYAMA ◽  
TOMOAKI MORIOKA ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Endothelial Function ◽  
Diabetic Kidney Disease ◽  
Vascular Endothelial ◽  
Vascular Endothelial Function ◽  
Diabetic Kidney

Progression of diabetic kidney disease and trajectory of kidney function decline in Chinese patients with Type 2 diabetes

2019 ◽  
Vol 95 (1) ◽  
pp. 178-187 ◽  
Author(s):  
Guozhi Jiang ◽  
Andrea On Yan Luk ◽  
Claudia Ha Ting Tam ◽  
Fangying Xie ◽  
Bendix Carstensen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Kidney Function ◽  
Diabetic Kidney Disease ◽  
Chinese Patients ◽  
Diabetic Kidney ◽  
Kidney Function Decline

scholarly journals Association Between Classical and Emerging Risk Factors for Diabetic Kidney Disease and Albuminuria in a Cohort of Type 2 Diabetes Mellitus Patients

2021 ◽  
Vol 18 (3) ◽  
pp. 17-25
Author(s):  
Stoiţă Marcel ◽  
Popa Amorin Remus
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Significant Positive Association ◽  
Diabetic Kidney

Abstract The presence of albuminuria in patients with type 2 diabetes mellitus is a marker of endothelial dysfunction and also one of the criteria for diagnosing diabetic kidney disease. The present study aimed to identify associations between cardiovascular risk factors and renal albumin excretion in a group of 218 patients with type 2 diabetes mellitus. HbA1c values, systolic blood pressure, diastolic blood pressure were statistically significantly higher in patients with microalbuinuria or macroalbuminuria compared to patients with normoalbuminuria (p <0.01). We identified a statistically significant positive association between uric acid values and albuminuria, respectively 25- (OH)2 vitamin D3 deficiency and microalbuminuria (p <0.01).

scholarly journals Diabetic kidney disease: Act now or pay later

2008 ◽  
Vol 11 (4) ◽  
pp. 988-991
Author(s):  
Robert C Atkins ◽  
Paul Zimmet
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
International Society ◽  
Diabetic Kidney Disease ◽  
International Diabetes Federation ◽  
Diabetic Kidney ◽  
Global Pandemic

In 2003, the International Society of Nephrology and the International Diabetes Federation launched a booklet called “Diabetes in the Kidney: Time to act” [1] to highlight the global pandemic of type 2 diabetes and diabetic kidney disease. ration (PZ)

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