Blood Viscosity in Patients with Diabetic Nephropathy Versus Blood Viscosity in Healthy Patients

Abstract Diabetic nephropathy is the major cause of severe renal impairment and even chronic terminal renal failure requiring dialysis. Blood viscosity is clearly modified in diabetic patients, and particularly in those with severe renal impairment The purpose of this study is to highlight blood viscosity values at different shear rates in patients with diabetic nephropathy compared to the control group. There is a significant increase in blood viscosity in patients with definite renal impairment.

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The Significance of Urinary Markers in the Evaluation of Diabetic Nephropathy

Journal of Medical Biochemistry ◽

10.2478/v10011-008-0019-y ◽

2008 ◽

Vol 27 (3) ◽

pp. 376-382 ◽

Cited By ~ 5

Author(s):

Tatjana Cvetković ◽

Predrag Vlahović ◽

Vidosava đorđević ◽

Lilika Zvezdanović ◽

Dušica Pavlović ◽

...

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Urine Concentration ◽

Control Group ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Urinary Markers ◽

Stress Markers

The Significance of Urinary Markers in the Evaluation of Diabetic Nephropathy Oxidative stress is considered to be a unifying link between diabetes mellitus (DM) and its complications, including nephropathy (DN). The aim of this study was to determine the parameters of oxidative injury of lipids and proteins as well as the activity of ectoenzymes in the urine of DN patients. The study included 40 individuals: 10 patients with type 2 diabetes mellitus and microalbuminuria (DMT2-MIA), 10 type 2 diabetic patients with macroalbuminuria (DMT2-MAA), 10 patients with type 1 diabetes and microalbuminuria (DMT1-MIA) and 10 age- and sex-matched healthy subjects (control). In the urine we determined TBA reactive substances (TBARS), reactive carbonyl groups (RCG), and the activity of ectoenzymes N-acetyl-β-d-glucosaminidase (NAG), plasma cell differentiation antigen (PC-1), aminopeptidase N (APN) and dipeptidyl peptidase IV (DPP IV). A higher concentration of TBARS in the urine was found in DMT2-MIA and DMT1-MIA, compared to the control group (p<0.001 and P<0.05). The urine concentration of RCD shows similar results with a significant elevation in the groups with DMT2-MAA and DMT1-MIA, compared to the DMT2-MIA (p<0.001) and control group (p<0.001). Activities of NAG, APN and DPPIV were significantly higher in the urine of DMT2-MAA, compared to the control (p<0.01). The activity of PC-1 was slightly increased in that group, but not significantly. In conclusion, the level of oxidative stress markers and activities of brush border ectoenzymes in the urine may be a useful non-invasive and easily repeatable test in DN.

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Analysis of Phase 3 telavancin nosocomial pneumonia data excluding patients with severe renal impairment and acute renal failure

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkt490 ◽

2014 ◽

Vol 69 (4) ◽

pp. 1119-1126 ◽

Cited By ~ 24

Author(s):

A. Torres ◽

E. Rubinstein ◽

G. R. Corey ◽

M. E. Stryjewski ◽

S. L. Barriere

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Renal Impairment ◽

Nosocomial Pneumonia ◽

Severe Renal Impairment ◽

Phase 3

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Elabela levels in patients with type 2 diabetes: can it be a marker for diabetic nephropathy?

African Health Sciences ◽

10.4314/ahs.v20i2.37 ◽

2020 ◽

Vol 20 (2) ◽

pp. 833-840

Author(s):

Erhan Onalan ◽

Yusuf Doğan ◽

Ebru Onalan ◽

Nevzat Gozel ◽

Ilay Buran ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Nephropathy ◽

High Serum ◽

Control Group ◽

Diabetic Patients ◽

Healthy Individuals ◽

Urine Albumin ◽

Healthy Control ◽

Group 2

Backround: Elabela (ELA) is a hormone that is secreted at high levels in the kidneys of a healthy adult. This study aims to investigate whether serum ELA levels of patients with Type 2 Diabetes vary with the severity of renal damage. Methods: Our study included 50 healthy control subjects and 100 diabetic patients, who were categorized into groups based on urine albumin/creatinine ratios (ACR). Patients included in the study were assigned to four groups: Group 1 (healthy control), Group 2 (ACR<29mg/g), Group 3 (ACR=30-299 mg/g), and Group 4 (ACR>300 mg/g normal or high serum creatinine). Physical examination findings, demographic characteristics of the study group were recorded, and serum ELA levels and other laboratory parameters were assessed using appropriate methods. Results: The results of the study indicated that ELA levels determined in healthy individuals gradually decreased through stages of normal albuminuria, microalbuminuria, and macroalbuminuria. Moreover, ELA had a significant negative corre- lation with LDL-C (r=-0.201, p=0.014), glucose (r=-0.437, P<0.001), retinopathy (r=-0.222, P=0.006), serum BUN (r=- 0.161, P=0.049), and a positive correlation with eGFR (r=0.250, P=0.002). Conclusions: The fact that ELA levels are higher in healthy individuals compared to diabetic patients without microalbu- minuria, and higher in diabetic patients without microalbuminuria compared to patients with advanced albuminuria and kidney damage, suggests that the ELA level can be an important clinical prognostic variable and even a promising agent for the treatment of diabetic nephropathy patients. Keywords: Elabela, diabetes, diabetic kidney disease, albuminuria.

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Podocalyxin as an early marker predicting diabetic nephropathy and its correlation with stages of diabetic nephropathy in type two diabetic patients

QJM ◽

10.1093/qjmed/hcab100.097 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Salah El-Din A Shelbaya ◽

Hanan M Ali ◽

Rana H Ibrahim ◽

Nourhan Safwat Sawirs

Keyword(s):

Diabetic Nephropathy ◽

Renal Disease ◽

End Stage Renal Disease ◽

Control Group ◽

Diabetic Patients ◽

Type 2 Dm ◽

Stage Renal Disease ◽

End Stage ◽

Positive Significant Correlation

Abstract Background Nephropathy, a major complication of diabetes, is the leading cause of end-stage renal disease. Early identification of nephropathy in diabetes patients is crucial because it creates opportunity for preventing the incidence of DN and/or even slows down the process of end-stage renal disease attributed to diabetes. Human podocytes (Pods) have been demonstrated to be functionally and structurally injured in the natural history of diabetic nephropathy. Aim of the Work To evaluate the possible association between the urinary podocalyxin levels and severity and grade of diabetic nephropathy and to use urinary podocalyxin as a non-invasive marker for early stage of diabetic nephropathy in type 2 DM. Patients and Methods We collected 60 known clinically and biochemically type 2 diabetic patients.20 diabetic patients with no evidence of diabetic nephropathy, 20 patients diagnosed as diabetic nephropathy in microalbuminuria stages and 20 patients diagnosed as diabetic nephropathy in macroalbuminuria stages from Ain Shams University hospitals between April and December 2018 and 20 apparently healthy volunteers will included as a control group. Results Urinary PCX was significantly higher in patients group compared to control group. Urinary PCX was significantly higher in microalbuminuric group than in normoalbuminuric group and higher in macroalbuminuric group than in microalbuminuric group. There was a positive significant correlation between FBS, 2HrPP, HBA1C and urinary PCX. There was a positive significant correlation between s.create and urinary PCX. There was a positive significant correlation between ACR and urinary PCX. Conclusion Urinary podocalyxin seems to be beneficial as an early marker for early stages of diabetic nephropathy in type 2 DM patients.

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Wnt signaling and podocyte dysfunction in diabetic nephropathy

Journal of Investigative Medicine ◽

10.1136/jim-2017-000456 ◽

2017 ◽

Vol 65 (8) ◽

pp. 1093-1101 ◽

Cited By ~ 24

Author(s):

Madhura Bose ◽

Sadia Almas ◽

Sharma Prabhakar

Keyword(s):

Diabetes Mellitus ◽

Renal Failure ◽

Diabetic Nephropathy ◽

Wnt Signaling ◽

Therapeutic Strategies ◽

Podocyte Injury ◽

Functional Changes ◽

Terminal Renal Failure ◽

Cardiovascular Morbidity And Mortality

Nephropathy is a major microvascular complication of diabetes mellitus and often leads to terminal renal failure in addition to contributing significantly to cardiovascular morbidity and mortality. Despites continuous advances, the pathogenesis of diabetic nephropathy remains poorly understood. Recent studies have underscored the significance of structural and functional changes in podocytes in the development and progression of diabetic nephropathy. The role of podocytes in health and diabetic nephropathy and abnormalities including podocyte hypertrophy, effacement, and apoptosis, and a detailed discussion on the role played by the Wnt-β-catenin signaling pathway in podocyte injury and dysfunction are the focus of this review. In addition, the role played by Wnt signaling in mediating the effects of known therapeutic strategies for diabetic nephropathy is also discussed.

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Evaluation of urinary L-FABP as an early marker for diabetic nephropathy in type 2 diabetic patients

Journal of Medical Biochemistry ◽

10.2478/jomb-2019-0037 ◽

2019 ◽

Vol 0 (0) ◽

Cited By ~ 1

Author(s):

Duong Thi Thuy Ngan ◽

Nguyen Gia Binh ◽

Le Thi Huong Lan ◽

Cuc Thi Thu Nguyen ◽

Phung Thanh Huong

Keyword(s):

Renal Function ◽

Diabetic Nephropathy ◽

Early Detection ◽

Urinary Albumin ◽

Control Group ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Fatty Acid Binding ◽

Type 2 Diabetic

Summary Background Albuminuria is the standard biomarker for the diagnosis of diabetic nephropathy (DN). However, some patients with persistent microalbuminuria still progress to chronic kidney disease, raising the question of finding a better biomarker. This study aimed to evaluate the correlation of urinary liver-type fatty acid-binding protein (L-FABP) levels with renal function and to compare the role of urinary albumin-to-creatinine ratio (ACR) with urinary L-FABP in early detection of DN in type 2 diabetic patients. Methods The cross-sectional study was done on 106 type 2 diabetic patients and 30 non-diabetic people. L-FABP was measured with the Latex enhanced immunoturbidimetric technique. Results There was a strong and negative correlation between the urine L-FABP levels and eGFR (r = -0.606, p<0.001). The urinary L-FABP levels were significantly higher (p<0.001) in the normoalbuminuria diabetic group than the non-diabetic control group. The ROC-curve analyses in the diabetic patients and the normoalbuminuria diabetic patients showed that the AUCL-FABP was remarkably higher (p<0.001) than the AUCACR. An optimal cutoff value of 5 mg L-FABP/g Cr (with the sensitivity of 98.1% and specificity of 90%) and of 4.3 mg L-FABP/g Cr (with the sensitivity of 100% and specificity of 86.67%) was set to detect DN in the diabetic patients and the normoalbuminuria diabetic patients, respectively. Conclusions The change in urinary L-FABP levels happened earlier than in urinary albumin during renal function impairment. Urinary L-FABP can be used as a better indicator than ACR for early detection of DN in type 2 diabetes.

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Profile of Diabetic Nephropathy in Southern Morocco

10.21203/rs.3.rs-282189/v1 ◽

2021 ◽

Author(s):

SANAA BENBRIA ◽

Abdelaali BAHADI ◽

Youssef ZORKANI ◽

MOUNIA AZIZI ◽

yassir zajjari ◽

...

Keyword(s):

Renal Failure ◽

Renal Function ◽

Diabetic Nephropathy ◽

Renin Angiotensin System ◽

Biological Data ◽

Diabetic Patients ◽

Early Management ◽

Angiotensin System ◽

Renin Angiotensin

Abstract Diabetic nephropathy (DN) has a steadily increasing prevalence, particularly because of the increase in sedentary lifestyle and obesity. It is defined as the persistent presence of albuminuria in a diabetic patient and requires early management to prevent progression to end-stage renal failure. The purpose of this work is to describe the epidemiologic profile and the progression of DN for the first time in a southern Moroccan region: Guelmim Oued noun - Moroccan Sahara.Patients and methods: It is a retrospective study conducted at the 5th military hospital in Guelmim and including all diabetic patients seen in nephrology consultation between January 2015 and December 2018. We collected the following parameters of our patients: demographics, comorbidities, prescribed treatments and biological data (Albuminuria, renal function and glycated hemoglobin) during their nephrology follow-up.Résults: During the study period 267 diabetic patients were included among 1042 patients, which represented 25.9% of the nephrology consultation activity. Their average age was 64.3 years with a slight male predominance (60%) and only two patients had type 1 diabetes. At the first nephrology consultation the average duration of diabetes was 14.6 years, 61 (22.8%) patients were on diet alone, 95 (35.5%) on oral antidiabetic drugs (OADs), 94 (35.2%) on insulin and 35 (13%) on OAD and insulin. Half the patients were hypertensive and 107 (40%) already had a cardiovascular complication (arterial disease, coronary artery disease or stroke). The average initial albuminuria was 388 mg/24h and the average glomerular filtration rate (GFR) was 67 ml/min ; 115 (43%) patients being in renal failure. 46 (17%) patients had no renal function assessment during their previous follow-up and only 139 (52%) were on renin-angiotensin system inhibitors (RASIs). After 12-month-follow-up in nephrology, the average GFR was 70 ml/min and 64 ml /min after two years.Conclusion: Diabetic nephropathy accounts for at least a quarter of nephrology consultation activity in the region of Guelmim Oued Noun. It is characterized in this context by the delay in treatment using renin angiotensin system inhibitors and late nephrology referral hence the need to strengthen preventive strategies in this region especially continuous training.

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Antihyperglycaemic, haemorheological and antioxidant activities of Lychnis chalcedonica L. extract in a streptozotocin-induced rat model of diabetes mellitus

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2017-0028 ◽

2019 ◽

Vol 17 (2) ◽

Author(s):

Mark B. Plotnikov ◽

Larisa N. Zibareva ◽

Aleksander S. Vasil’ev ◽

Oleg I. Aliev ◽

Anna M. Anishchenko ◽

...

Keyword(s):

Rat Model ◽

Antioxidant Activities ◽

Conjugated Dienes ◽

Flowering Plant ◽

Diabetic Rat ◽

Control Group ◽

Diabetic Patients ◽

Control Groups ◽

Shear Rates ◽

Rbc Aggregation

AbstractBackgroundNew therapeutic strategies, such as the use of agents to correct rheological disorders, are needed for the prevention and treatment of angiopathy in diabetic patients. The aim of this work was to study the antihyperglycaemic, haemorheologic and antioxidant activities of an extract from the flowering plant Lychnis chalcedonica L. (ELC) and 20-hydroxyecdysone using the streptozotocin-induced model of diabetic rats.MethodsThe streptozotocin-induced model of diabetes was produced using streptozotocin at a dose of 50 mg/kg (ip). Animals from the experimental groups were treated with ELC (150 mg/kg) or 20-hydroxyecdysone (1.1 mg/kg) intragastrically in 1% aqueous starch mucilage daily, for 14 days; rats of control groups received an equal volume of starch mucilage. The following parameters were measured: glucose concentration (GC) in blood, whole blood viscosity (WBV), conjugated dienes in RBC membranes. Macro- and microrheological indicators (viz. plasma viscosity, haematocrit, RBC aggregation (T1/2) and the RBC elongation index (EI)) were additionally measured in rats that received ELC, and in the control group.ResultsAfter treatment with ELC, the GC in rats was 19% lower than that in the control group (14.7 ± 0.9 mM compared to 18.2 ± 1.1 mM). Rats with streptozotocin-induced diabetes have hyperviscosity syndrome, which is characterized by increased WBV, increased RBC aggregation and decreased deformability. ELC treatment reduced WBV at shear rates of 10–90 s−1 by 5–8%, and T1/2 and EI in the experimental group were 31% and 5–10% higher compared to the control group. 20-Hydroxyecdysone decreased WBV at shear rates of 10–90 s−1 by 3–11%. Finally, ELC and 20-hydroxyecdysone lowered the content of conjugated dienes by 27% and by 26% compared to the control groups.ConclusionIn the streptozotocin-induced diabetic rat model, ELC showed measurable antihyperglycaemic activity; ELC and 20-hydroxyecdysone demonstrated similar haemorheological, and antioxidant activities.

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Renal Effects of Sulodexide in Type 2 Diabetic Patients without Nephrotic Range Proteinuria

Journal of Diabetes Research ◽

10.1155/2020/2984680 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Kachonsak Yongwatana ◽

Ouppatham Supasyndh ◽

Bancha Satirapoj

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Renal Function ◽

Diabetic Nephropathy ◽

Control Group ◽

Diabetic Patients ◽

Long Term Effects ◽

Renal Disease Progression ◽

Significant Difference

Background. Glycosaminoglycan plays an important role in the maintenance of glomerular charge selectivity of diabetic nephropathy. Sulodexide, a mixture of naturally occurring glycosaminoglycan polysaccharide components, has shown a nephroprotective effect in an experimental model of diabetic nephropathy. Although sulodexide reduced albuminuria in patients with type 1 and type 2 diabetes, long-term effects in patients with type 2 diabetes with significant proteinuria have not been established. Objectives. The study was aimed at investigating the effects of sulodexide on proteinuria and renal function in patients with type 2 diabetes and nephropathy. Methods. Fifty-two patients with proteinuria between 500 and 3000 mg/day received sulodexide 200 mg/day for 12 months, while 56 matched patients with type 2 diabetes constituted the control group. All patients received standard metabolic and blood pressure controls. Primary outcome was evaluated as percentage of reduced proteinuria compared with the control group. Renal function was assessed using estimated glomerular filtration rate (GFR). Results. Proteinuria significantly increased in the control group [0.9 (IQR 0.3 to 1.78) to 1.16 (IQR 0.44 to 2.23) g/gCr, P=0.001], whereas it remained stable in the sulodexide group [0.66 (IQR 0.23 to 0.67) to 0.67 (IQR 0.17 to 1.51) g/gCr, P=0.108]. At 12 months, proteinuria was higher by 19.4% (IQR 10.3 to 37.6) in the control group while proteinuria was lower by -17.7% (IQR -53.1 to 3.2) in the sulodexide group with a significant difference between groups (P=0.001). Renal function was noted as a change of estimated GFR, and serum creatinine decreased significantly during the study in both groups but did not significantly differ between groups. No significant changes in the blood pressure, fasting plasma glucose, and hemoglobin A1C were reported. Conclusion. In addition to standard treatment, sulodexide is efficient in maintaining proteinuria in patients with type 2 diabetes with nonnephrotic range proteinuria, but it did not provide an additional benefit concerning renal disease progression.

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