Elevated Serum Levels of Carbohydrate Antigen 72–4 in Diabetic Kidney Disease

AbstractThe aim of this study was to determine whether carbohydrate antigen 72–4 (CA72–4) is elevated in diabetic kidney disease (DKD), and examine the association between urinary albumin-to-creatinine ratio (UACR) and CA72–4 in patients with type 2 diabetes mellitus (T2DM). Non-dialysis patients with T2DM (n=296) and 90 healthy controls were recruited in this study. CA72–4 level was measured by electrochemiluminescence immunoassay. DKD was defined as UACR≥ 30 mg/g in the absence of a urinary infection or other renal diseases. We found that patients with DKD had significantly higher serum CA72–4 levels compared to those with normoalbuminuria and healthy controls. Positive rates of CA72–4 increased gradually and markedly from normoalbuminuria to microalbuminuria and to macroalbuminuria in diabetic patients (7.5, 11.2, and 17.4%, respectively; P for trend< 0.05). CA72–4 also showed a positive correlation with UACR (r=0.288, P< 0.01). Logistic regression analysis revealed the association of increased UACR with an increased odds ratio of elevation of CA72–4 levels (P for trend< 0.05) after multivariable adjustment. In conclusion, serum levels of CA72–4 increase abnormally with the increase in urinary albumin excretion, which affects the specificity of diagnosis of malignancies. An appropriate interpretation of CA72–4 is essential to prevent unnecessary and even hazardous diagnostic procedures in patients with T2DM.

Download Full-text

MO580HYPOPROTEIC DIET SUPPLEMENTED WITH KETOANALOGUES IN PATIENTS WITH ADVANCED DIABETIC KIDNEY DISEASE – EFFECTS ON MINERAL BONE DISORDERS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab086.0018 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Liliana Garneata ◽

Carmen-Antonia Mocanu ◽

Tudor Petrisor Simionescu ◽

Andreea Elena Mocanu ◽

Gabriel Mircescu

Keyword(s):

Kidney Disease ◽

Diabetic Kidney Disease ◽

Serum Levels ◽

Protein Diet ◽

Low Protein Diet ◽

Diabetic Patients ◽

Bone Disorders ◽

Diabetic Kidney ◽

Low Protein ◽

Ckd Stage

Abstract Background and Aims Dietary protein restriction is rediscussed as mainstay approach in advanced Chronic Kidney Disease (CKD), both in diabetics and non-diabetics to defer renal replacement therapy (RRT), mainly by better metabolic control; improvements in mineral bone disorders (MBD) were also suggested, but less studied in Diabetic Kidney Disease (DKD). An unicentric prospective interventional trial aimed to assess the effects of ketoanalogue-supplemented low protein diet (sLPD) on proteinuria and CKD progression (data already presented). The parameters of MBD were also evaluated. Method Adult diabetic patients (452) with stable CKD stage 4+, proteinuria>3g/g creatininuria and SGA A were enrolled in a run-in phase (3 mo), with LPD (0.6g/kg dry ideal bw). Those who proved adherent (92, 64% males, median age 55.7 yrs, 65% on insulin) received sLPD (Ketosteril®, 1 tablet/10kg) for 12mo. Monitoring and treatment followed the Best Practice Guidelines. The primary endpoint was proteinuria during intervention as compared to pre-enrolment. Serum levels of calcium, phosphates and iPTH were considered to assess MBD. Nutrition, inflammation (SGA, BMI, serum albumin, CRP) and compliance were safety parameters. Results In patients with advanced DKD and severe proteinuria, sLPD was associated with a 69 (63; 82) % reduction in proteinuria (data presented). Significant amelioration in MBD was noted: serum levels of calcium and phosphates were significantly ameliorated at the end of the study as compared to enrolment - 4.3 (4.2-4.9) vs 3.2 (3.1-3.5) mg/dL and 5.4 (4.9-6.1) vs 8.2 (7.8-8.9) mg/dL, respectively. Serum iPTH significantly decreased: 185 (168-212) vs 375 (354-585) pg/mL. The need for calcium supplementation decreased: 6.5 (6.0-6.7) vs 7.0 (6.8-7.3) g/day. Vitamin D was required by only 35% vs 65% of patients. Nutritional status was preserved and dietary compliance was very good throughout the study. Conclusion In patients with advanced DKD ketoanalogue supplemented low protein diet seems to be effective and safe as part of MBD management.

Download Full-text

MO636THE ROLE OF DIFFUSION-WEIGHTED MRI AND APPARENT DIFFUSION COEFFICIENT IN ASSESSMENT OF DIABETIC KIDNEY DISEASE: PRELIMINARY EXPERIENCE STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab094.004 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Mohamed Taha

Keyword(s):

Kidney Disease ◽

Diabetic Kidney Disease ◽

Structural Changes ◽

University Hospital ◽

Poor Correlation ◽

Diabetic Patients ◽

Healthy Controls ◽

Adc Value ◽

Diabetic Kidney ◽

Adc Values

Abstract Background and Aims Diabetic kidney disease is the most common cause of ESRD. There is poor correlation between the degree of renal fibrosis and current screening markers. A noninvasive imaging technique is needed to assess the degree of structural changes in the kidney. Method Forty adult diabetic patients with chronic kidney disease as well as 20 age- and sex-matched adult healthy controls were recruited from Nephrology Department of our University Hospital. All patients underwent renal MR-DWI and ADC mapping on a 1.5-T scanner (Philips Achieva) using phased array body coil. Results Among the studied 40 diabetic patients, five groups of patients were resulted 8 patients for each and the ADC values were inversely correlated with advancement in renal parenchymal affection, ie, in late stages of the disease the ADC values were lower than in early stages. The mean ADC values of renal parenchyma in patients with diabetic kidney disease were considerably lower than that of healthy controls with normal renal function (2.1± 0.3x10− 3 mm2/s vs 2.4± 0.1x10− 3 mm2/s with p< 0.001). Conclusion ADC value is a possible noninvasive technique in evaluating the stage of renal dysfunction with assessment of disease progression.

Download Full-text

Association of Stromal Cell-derived Factor-1 With Diabetic Kidney Disease in Type 2 Diabetic Patients

10.21203/rs.3.rs-144263/v1 ◽

2021 ◽

Author(s):

Chunfeng Lu ◽

Jianhua Ma ◽

Xueqin Wang ◽

Wangshu Liu ◽

Xiaoqin Ge

Keyword(s):

Kidney Disease ◽

Stromal Cell ◽

Diabetic Kidney Disease ◽

Critical Role ◽

Urinary Albumin ◽

Diabetic Patients ◽

Characteristic Analysis ◽

Diabetic Kidney ◽

Stromal Cell Derived Factor

Abstract Background: The present study was designed to explore whether serum stromal cell-derived factor-1 (SDF-1) levels were associated with albuminuria, estimated glomerular filtration rate (eGFR) and diabetic kidney disease (DKD), and detect which clinical parameters might affect serum SDF-1 levels in patients with type 2 diabetes (T2D).Methods: Serum SDF-1 levels were measured by sandwich ELISA. Patients with an eGFR < 60ml/min/1.73m2 and/or a urinary albumin-to-creatinine ratio (UACR) ≥ 30mg/g who presented with diabetic retinopathy were identified as having DKD.Results: Serum SDF-1 levels in T2D patients were significantly higher than those in healthy controls (p < 0.05). Urinary albumin and UACR were positively correlated with serum SDF-1 levels (r = 0.216 and = 0.276, respectively, p < 0.01), and eGFR was inversely related with serum SDF-1 levels (r = -0.368, p < 0.001). Moreover, after adjusting for other clinical covariates by multiple linear regression analyses, the serum SDF-1 levels were independently associated with urinary albumin (β = 0.071, t = 2.185, p < 0.05), UACR (β = 0.071, t = 2.077, p < 0.05) and eGFR (β = -3.975, t = -3.375, p < 0.01). Furthermore, receiver operating characteristic analysis indicated that the optimal SDF-1 cutoff value for predicting macroalbuminuria was 5.735 ng/mL (its corresponding sensitivity was 50.00% and specificity was 81.46%), for predicting abnormal albuminuria was 4.321 ng/mL (its corresponding sensitivity was 58.46% and specificity was 70.78%) and for predicting DKD was 3.505 ng/mL (its corresponding sensitivity was 83.33% and specificity was 42.86%).Conclusions: The serum SDF-1 levels were positively associated with urinary albumin, UACR and cystatin C, and negatively associated with eGFR, which indicate that SDF-1 may play a critical role in the onset and progression of DKD.

Download Full-text

XOR - Possible Correlations with Oxidative Stress and Inflammation Markers in the Context of Diabetic Kidney Disease

Revista de Chimie ◽

10.37358/rc.19.4.7135 ◽

2019 ◽

Vol 70 (4) ◽

pp. 1396-1398 ◽

Cited By ~ 1

Author(s):

Alexandra Totan ◽

Andra-Elena Balcangiu-Stroescu ◽

Marina Melescanu Imre ◽

Daniela Miricescu ◽

Daniela Balan ◽

...

Keyword(s):

Oxidative Stress ◽

Kidney Disease ◽

Diabetic Kidney Disease ◽

Microvascular Complications ◽

Serum Levels ◽

Control Group ◽

Diabetic Patients ◽

Inflammation Markers ◽

Diabetic Kidney ◽

Diabetic Microvascular Complications

Xanthine oxidoreductase (XOR) activity plays an important role as a pivotal source of reactive oxygen species. The aim of our study was to investigate possible correlations of XOR serum levels with oxidative stress (total antioxidant capacity - TAC, anti-oxidative stress responsive 1 antibody - OXSR1) and inflammation markers (interleukin 6 - IL-6), in 20 hemodialysis diabetic patients. The present study included the hemodialysis diabetic patients group (10 males and 10 females) and the control group (20 healthy volunteers). For serum XOR (ng/mL), TAC (U/mL) and OXSR1 (ng/ml) measurements we have used the ELISA technique. Serum IL6 (pg/mL) was performed using an automatic immunoassay system (Immulite 1000, Siemens- Germany). Comparing the two groups, our results revealed significantly increased serum levels for XOR (6.2�1.5 / 3.9�1.1); OXSR1 (11.3�2.9 / 6.2�2.1) and IL6 (7.0�1.2 / 5.0�0.4). Patients� serum levels of TAC were significantly decreased compared with the control group values (25.2�3.9 / 33.5�2.8). It becomes more and more obvious that oxidative stress is an important element initiating diabetic microvascular complications, including diabetic kidney disease. Our results suggested that XOR should be regarded as an important target in the attempt to reduce oxidative stress in the context of diabetic kidney disease.

Download Full-text

TGF-β1 and VCAM-1 Serum Concentrations as Diagnostic Biomarkers of Diabetic Kidney Disease Progression

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.2478/rjdnmd-2019-0018 ◽

2019 ◽

Vol 26 (2) ◽

pp. 169-175 ◽

Cited By ~ 1

Author(s):

Natalia Pertseva ◽

Inna Borysova ◽

Daria Chub

Keyword(s):

Kidney Disease ◽

Transforming Growth Factor Beta ◽

Diabetic Kidney Disease ◽

Transforming Growth Factor ◽

Quantitative Detection ◽

Enzyme Linked Immunosorbent Assay ◽

Diabetic Patients ◽

Healthy Controls ◽

Diabetic Kidney ◽

Tgf Β1

Abstract Background and aims: Transforming growth factor-beta 1 (TGF-β1) and vascular adhesion molecule 1 (VCAM-1) have been proposed as promising biomarkers for multiple diseases. TGF-β1 and VCAM-1 are reported to be associated with diabetic kidney disease (DKD) and end stage renal disease in patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM). Material and methods: The aim of this study was to investigate the expression of circulating TGF-β1 and VCAM-1 and to assess their potential as a blood-based biomarker for DKD in T1DM and T2DM patients. Results:. The study included 124 participants: 66 patients with T1DM, 58 with T2DM and 20 healthy controls. The diabetic patients were classified according to the estimated glomerular filtration rate (eGFR). First group - eGFR ≥90ml/min/1.73 m2 (n=39), second group eGFR 89-60 ml/min/1.73m2 (n=45), and third group eGFR 59-45 ml/min/1.73m2 (n=40). Enzyme-linked immunosorbent assay for the quantitative detection of was used to evaluate blood TGF-β1 and VCAM-1 expression. It was found that there were higher TGF-β1 and VCAM-1 in all diabetic patients compared with healthy controls (P<0.05). TGF- β1 and VCAM-1 were higher in group with eGFR ≥90ml/min/1.73 m2 and gradually increased in the groups with eGFR89-60 ml/min/1.73m2 and eGFR 59-45 ml/min/1.73m2. TGF- β1 and VCAM-1 were less in T1DM, than T2DM in all study groups. Regression analysis revealed reverse associations between TGF- β1, VCAM-1 and eGFR (P<0.05). TGF- β1 and VCAM-1 correlated positively with albuminuria and negatively with renal function. Conclusion: In discriminating overall patients from healthy subjects, ROC analysis revealed areas under the curve (AUCs) of 1,0 for TGF- β1 for T1DM and T2DM, VCAM-1 0,866 for T1DM, 0,923 for T2DM (P<0.001). The results suggested that blood-based TGF- β1 and VCAM-1 may serve as potential biomarkers for early detection of DKD.

Download Full-text

539-P: The Trend of Diabetic Kidney Disease with Low eGFR and Absence of Albuminuria in Type 2 Diabetic Patients in Japan from 1996-2015

Diabetes ◽

10.2337/db19-539-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 539-P

Author(s):

YOSHINORI KAKUTANI ◽

MASANORI EMOTO ◽

KATSUHITO MORI ◽

YUKO YAMAZAKI ◽

AKINOBU OCHI ◽

...

Keyword(s):

Kidney Disease ◽

Diabetic Kidney Disease ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Diabetic Kidney ◽

Type 2 Diabetic

Download Full-text

Urinary Extracellular Vesicles for Diabetic Kidney Disease Diagnosis

Journal of Clinical Medicine ◽

10.3390/jcm10102046 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2046

Author(s):

Goren Saenz-Pipaon ◽

Saioa Echeverria ◽

Josune Orbe ◽

Carmen Roncal

Keyword(s):

Kidney Disease ◽

Extracellular Vesicles ◽

Diabetic Kidney Disease ◽

Current Knowledge ◽

Developed Countries ◽

Disease Diagnosis ◽

Renal Diseases ◽

Diabetic Kidney ◽

Glucose Levels ◽

Stage Renal Disease

Diabetic kidney disease (DKD) is the leading cause of end stage renal disease (ESRD) in developed countries, affecting more than 40% of diabetes mellitus (DM) patients. DKD pathogenesis is multifactorial leading to a clinical presentation characterized by proteinuria, hypertension, and a gradual reduction in kidney function, accompanied by a high incidence of cardiovascular (CV) events and mortality. Unlike other diabetes-related complications, DKD prevalence has failed to decline over the past 30 years, becoming a growing socioeconomic burden. Treatments controlling glucose levels, albuminuria and blood pressure may slow down DKD evolution and reduce CV events, but are not able to completely halt its progression. Moreover, one in five patients with diabetes develop DKD in the absence of albuminuria, and in others nephropathy goes unrecognized at the time of diagnosis, urging to find novel noninvasive and more precise early diagnosis and prognosis biomarkers and therapeutic targets for these patient subgroups. Extracellular vesicles (EVs), especially urinary (u)EVs, have emerged as an alternative for this purpose, as changes in their numbers and composition have been reported in clinical conditions involving DM and renal diseases. In this review, we will summarize the current knowledge on the role of (u)EVs in DKD.

Download Full-text