Glomerular and tubular damage markers are elevated in patients with diabetes
- PMID: 21307379
- PMCID: PMC3064060
- DOI: 10.2337/dc10-1545
Glomerular and tubular damage markers are elevated in patients with diabetes
Abstract
Objective: We investigated in a cross-sectional study the levels of serum and urinary damage markers in diabetic patients (n = 94) and nondiabetic control subjects (n = 45) to study the association of glomerular (IgG), proximal tubular (kidney injury molecule [KIM]-1, N-acetyl-β-d-glucosaminidase [NAG], neutrophil gelatinase-associated lipocalin [NGAL], and cystatin C), and distal tubular (heart fatty acid-binding protein [H-FABP]) damage markers with kidney disease severity, as assessed by albuminuria and estimated glomerular filtration rate (eGFR).
Research design and methods: Damage markers were measured in triplicate in fresh morning urine samples and in plasma.
Results: Of the diabetic patients, 41 were normoalbuminuric, 41 were microalbuminuric, and 12 were macroalbuminuric. Urinary NAG (ninefold), NGAL (1.5-fold), and H-FABP (3.5-fold) were significantly elevated in normoalbuminuric diabetic patients compared with nondiabetic control subjects. Urinary concentrations of all markers increased per albuminuria stratum, except KIM-1. All urinary damage markers, except KIM-1, were significantly associated with albuminuria, independent of age, sex, and plasma concentrations of the corresponding biomarker (standard βs between 0.35 and 0.87; all P ≤ 0.001). All urinary damage markers, except KIM-1, were significantly associated with the eGFR in univariate models (standard βs between -0.38 and -0.21; all P < 0.04). After adjusting for age, sex, plasma concentration of the corresponding damage marker, and albuminuria, only the association of H-FABP with eGFR remained significant (standard β -0.26; P = 0.037).
Conclusions: Glomerular and tubular markers are associated with albuminuria, independently of eGFR, suggesting that albuminuria reflects both glomerular and tubulointerstitial damage. Only urinary H-FABP is associated with eGFR independently of albuminuria and, therefore, may be a promising urinary damage marker to assess diabetic kidney disease.
Figures
Similar articles
-
Biomarkers for early detection of sickle nephropathy.Am J Hematol. 2011 Jul;86(7):559-66. doi: 10.1002/ajh.22045. Epub 2011 May 31. Am J Hematol. 2011. PMID: 21630304 Free PMC article. Clinical Trial.
-
Nonalbuminuric proteinuria as a biomarker for tubular damage in early development of nephropathy with type 2 diabetic patients.Diabetes Metab Res Rev. 2014 Nov;30(8):736-41. doi: 10.1002/dmrr.2546. Diabetes Metab Res Rev. 2014. PMID: 24687388
-
Urinary tubular biomarkers in short-term type 2 diabetes mellitus patients: a cross-sectional study.Endocrine. 2012 Feb;41(1):82-8. doi: 10.1007/s12020-011-9509-7. Epub 2011 Jul 21. Endocrine. 2012. PMID: 21779943
-
Current developments in early diagnosis of acute kidney injury.Int Urol Nephrol. 2014 Jan;46(1):1-7. doi: 10.1007/s11255-013-0448-5. Epub 2013 May 15. Int Urol Nephrol. 2014. PMID: 23673775 Review.
-
Urinary and serum biomarkers for the diagnosis of acute kidney injury: an in-depth review of the literature.Nephrol Dial Transplant. 2013 Feb;28(2):254-73. doi: 10.1093/ndt/gfs380. Epub 2012 Oct 31. Nephrol Dial Transplant. 2013. PMID: 23115326 Review.
Cited by
-
Urinary biomarkers for early diabetic nephropathy in type 2 diabetic patients.Biomark Res. 2015 Jul 4;3:16. doi: 10.1186/s40364-015-0042-3. eCollection 2015. Biomark Res. 2015. PMID: 26146561 Free PMC article.
-
Urinary N-acetyl-β-D-glucosaminidase, an early marker of diabetic kidney disease, might reflect glucose excursion in patients with type 2 diabetes.Medicine (Baltimore). 2016 Jul;95(27):e4114. doi: 10.1097/MD.0000000000004114. Medicine (Baltimore). 2016. PMID: 27399115 Free PMC article.
-
FoxO1-mediated inhibition of STAT1 alleviates tubulointerstitial fibrosis and tubule apoptosis in diabetic kidney disease.EBioMedicine. 2019 Oct;48:491-504. doi: 10.1016/j.ebiom.2019.09.002. Epub 2019 Oct 16. EBioMedicine. 2019. PMID: 31629675 Free PMC article.
-
Kidney injury molecule-1: A potential marker of renal recovery after laparoscopic sleeve gastrectomy.Kidney Res Clin Pract. 2020 Jun 30;39(2):162-171. doi: 10.23876/j.krcp.19.109. Kidney Res Clin Pract. 2020. PMID: 32487784 Free PMC article.
-
Biomarkers of acute kidney injury after pediatric cardiac surgery: a meta-analysis of diagnostic test accuracy.Eur J Pediatr. 2022 May;181(5):1909-1921. doi: 10.1007/s00431-022-04380-4. Epub 2022 Jan 17. Eur J Pediatr. 2022. PMID: 35039910
References
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials
Miscellaneous
