scholarly journals Urinary nephrin is earlier, more sensitive and specific marker of diabetic nephropathy than microalbuminuria

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Irena Kostovska ◽  
Tosheska Trajkovska ◽  
Sonja Topuzovska ◽  
Svetlana Cekovska ◽  
Goce Spasovski ◽  
...  

Summary Background Diabetic nephropathy (DN) is a leading cause of end-stage renal disease. Progressive damage and decline in the number of podocytes often occur in the early stages of DN. Thus, nephrin as a podocyte-specific protein may be regarded as a potential biomarker of early detection of DN. The aim of this study is to determine whether urinary nephrin is an earlier marker in DN than microalbuminuria and to test the significance of urinary nephrin as a marker for early detection of DN. Methods Our cross-sectional study included 90 patients with type 2 diabetes mellitus (T2DM), 30 patients with diagnosed DN and 60 patients without diagnosed DN. As a control group, we used 30 healthy subjects. All patients with T2DM were classified into three subgroups according to urinary microalbumin/creatinine ratio (UMCR): normoalbuminuric, microalbuminuric and macroalbuminuric patients. Nephrin in urine was measured by immunoenzyme assay, microalbumin with turbidimetric and creatinine with the photometric method. In blood sera, we measured a few standard biochemical parameters. Results Nephrinuria was found to be present in 100% of patients with T2DM and macroalbuminuria, in 88% with microalbuminuria, as well as 82% of patients with T2DM and normoalbuminuria. A concentration of urinary nephrin was significantly increased in all groups of subjects with T2DM compared to the control group (p<0.05). Nephrinuria correlated statistically negative with eGFR (r=-0.54). ROC analysis showed that nephrin has a total predicted probability of 96% in patients with DN. Conclusions Urinary nephrin is earlier, more specific and sensitive marker than microalbumin in early detection of DN.

Author(s):  
Mohy Eldin Abd EL-Fattah ◽  
Taghrid B. El-abaseri ◽  
Hegazy Mohamed Abd Elaziz Mohamed

Background: Type 2 diabetes mellitus (DM) is the most common cause of end- stage renal disease. Albuminuria is the foremost commonly utilized marker to anticipate onset of diabetic nephropathy (DN) without sufficient affectability and specificity to identify early DN. Aim: This study aimed to evaluate Plasma cyclophilin A (CypA) as a new biomarker for early DN. Methods: This cross sectional study included 125 Egyptian subjects attending the out Patients Clinic of the Department of Internal Medicine, 10Th of Ramadan city Health Insurance Hospital and divided into-:control group, patient with diabetic mellitus, patients with Diabetic nephropathy and patient with diabetic nephropathy and other complications. Patients were subjected to measurement of plasma cyclophyline A, FBS, HbAIC, serum creatinine, serum urea, serum uric acid, k, Na, serum phosphorus, Albumin:Creatinine Ratio, GFR, Chol, TG, LDL HDL, AST, ALT, T.BIL, D.BIL ALB, TP, GLB and A/G ratio. Results: Results showed that Cyclophilin A was significantly correlated with duration of DM, CR, Urea, UR.A, Na, phosphorus, ACR, Chol, TG, LDL, AST, ALT, T.BIL, D.BIL. Meanwhile, Cyclophilin A was negatively correlated with HA1C, K, GFR, HDL, ALB, TP, GLB and A/G ratio. At cut-off level ≥84.14, cyclophilin A had 91% sensitivity and 62% specificity for diagnosing diabetic nephropathy. Conclusion: CypA can be used as an early marker for DN as we found early significant high levels of urinary CypA in diabetic patients with stage 2 DN even before the appearance of albuminuria.


2020 ◽  
Vol 58 (4) ◽  
pp. 233-241
Author(s):  
Irena Kostovska ◽  
Katerina Tosheska Trajkovska ◽  
Svetlana Cekovska ◽  
Sonja Topuzovska ◽  
Julijana Brezovska Kavrakova ◽  
...  

AbstractIntroduction. Podocyte injury has been reported as an early feature of DN therefore, the assessment of podocyte injury can be accomplished by estimation of podocalyxin in urine. This study aimed to estimate the urinary podocalyxin levels and to determine the sensitivity and specificity of this biomarker for early detection of DN.Materials and methods. A total of 90 patients with type 2 diabetes mellitus (T2DM) were included in this cross-sectional study. Sixty of them were without diagnosed DN, and 30 with diagnosed DN. A control group consisted of 30 healthy subjects. All patients with T2DM were divided into three subgroups according to urinary microalbumin/creatinine ratio (UM/CR): normoalbuminuric, microalbuminuric and macroalbuminuric patients. Urine samples, were used for measurement of podocalyxin by ELISA, creatinine and microalbumin. Fasting venous blood samples was collected for biochemical analyses.Results. The levels of urinary podocalyxin (u-PDX) were higher in patients with T2DM compared to control subjects and a statistically significant difference among studied subgroups regarding u-PDX was found (p < 0.05). Levels of u-PDX are increasing gradually with the degree of DN (p < 0.029). u-PDX levels were positively correlated with UM/CR (r = 0.227, p = 0.002). A cut-off level of 43.8 ng/ml u-PDX showed 73.3% sensitivity and 93.3% specificity to detect DN in early stage. A cut-off level of 30 mg/g UM/CR showed 41.5% sensitivity and 90% specificity in predicting DN. u-PDX was elevated in 48,2% of normoalbuminuric patients.Conclusion. Urinary podocalyxin be useful and more sensitive and specific marker in early detection of DN than microalbuminuria.


Author(s):  
Mohy Eldin Abd EL-Fattah ◽  
Taghrid B. El-abaseri ◽  
Hegazy Mohamed Abd Elaziz Mohamed

Background: Type 2 diabetes mellitus (DM) is the most common cause of end- stage renal disease. Albuminuria is the foremost commonly utilized marker to anticipate onset of diabetic nephropathy (DN) without sufficient affectability and specificity to identify early DN. Aim: This study aimed to evaluate plasma α-Klotho as a new biomarker for chronic diabetic nephropathy. Methods: This cross sectional study included 125 Egyptian subjects attending the out Patients Clinic of the Department of Internal Medicine, 10Th of Ramadan city Health Insurance Hospital and divided into:-control group, patient with diabetic mellitus, patients with Diabetic nephropathy and patient with diabetic nephropathy and other complications. Patients were subjected to measurement of plasma α- Klotho, FBS, HbAIC, serum creatinine, serum urea, serum uric acid, k, Na, serum phosphorus, Albumin: Creatinine Ratio, GFR, Chol, TG, LDL HDL, AST, ALT, T.BIL, D.BIL ALB, TP, GLB and A/G ratio. Results: Results showed that plasma a-klotho was significantly correlated with hemoglobin A1C, potassium, GFR, Albumin, TP and GLB. Meanwhile, plasma a- klotho was negatively correlated with duration of DM, CR, Urea, UR.A, Na, phosphorus, ACR, Chol, TG, LDL, AST, ALT, T.BIL, and D.BIL. However, there were no significant correlations between plasma α -klotho and FBS, HDL and A/G ratio. At cut-off level ≥2.6, plasma α -klotho had 95% sensitivity and 81% specificity for diagnosing diabetic nephropathy. Conclusion: α-klotho may be the chronic diabetic nephropathy markers for predicting renal injury in patients with type 2 diabetes.


2004 ◽  
Vol 10 (4-5) ◽  
pp. 620-626 ◽  
Author(s):  
A. Afifi ◽  
M. El Setouhy ◽  
M. El Sharkawy ◽  
M. Ali ◽  
H. Ahmed ◽  
...  

The prevalence of diabetic nephropathy as a cause of end-stage renal disease [ESRD] in Egypt has been examined in small cross-sectional studies, with conflicting results. The need for a large-scale study prompted us to perform this 6-year multiple cross-sectional study. A sample of ESRD patients enrolled in the Egyptian renal data system was evaluated during the period 1996-2001 for the prevalence of diabetic nephropathy. Prevalence gradually increased from 8.9% in 1996, to 14.5% in 2001. The mean age of patients with diabetic nephropathy was significantly higher than that of patients with ESRD from other causes. Mortality was also significantly higher in diabetic patients with ESRD


Author(s):  
Mariam A. Atiia ◽  
Yasser M. Hafez ◽  
Maaly M. Mabrouk ◽  
Medhat A. Ghazy

Background: Interleukin-19 (IL-19) is a newly discovered cytokine belonging to the Interleukin-10 (IL-10) family. IL-19 has indispensable functions in many inflammatory processes and also can induce the angiogenic potential of endothelial cells. The purpose of present study was to assess the level of serum interleukin-19 (IL-19) in patients with diabetic nephropathy (DN). Our Study Aimed to assess the level of serum IL-19 in patients with diabetic nephropathy. Methods: In this cross-sectional study, we tested 90 subjects; 30 healthy control and 60 diabetic nephropathy patients recruited from outpatient clinics and wards of Internal Medicine department, Tanta university hospitals, Egypt. Patients were subdivided into 3subgroup according to the urinary albumin creatinine ratio (ACR). Results: The serum IL-19 levels in DN patients were significantly higher than the control group. The mean serum IL-19 level was 15.45±4.34 Pg/ml, 32.66±8.05 Pg/ml, 56.03±7.89 Pg/ml and 71.41±12.37 Pg/ml dL for control, normoalbuminuria group, microalbuminuria group and macroalbuminuria group respectively. Conclusions: Serum IL-19 level was significantly elevated in patients with diabetic nephropathy and was associated with the marker of inflammation CRP (C -reactive protein). So


2020 ◽  
Vol 58 (3) ◽  
pp. 146-152
Author(s):  
Zahid Lepara ◽  
Orhan Lepara ◽  
Almir Fajkić ◽  
Damir Rebić ◽  
Jasmin Alić ◽  
...  

AbstractIntroduction. Bladder cancer is the most common malignancy involving the urinary system. Recent research tends to emphasize the role of oxidative stress products in the carcinogenesis of bladder cancer. The level of oxidative stress can be measured by assessing the MDA levels. This study aimed to evaluate serum MDA levels in patients with bladder cancer, as well as to determine its potential role as a biomarker in the diagnosis of the disease and progression risk considerations.Methods. The study was designed as a cross-sectional study and included 90 patients, divided into three groups with 30 patients each: Ta, T1and T2–T4 group, based on histopathological findings after transurethral resection of the tumor. The control group included 30 healthy volunteers. MDA level was determined using the spectrophotometric method.Results. Serum MDA level in patients with bladder cancer [0.86 (0.78–1.05) μmol/L] was significantly higher than the serum MDA level in control group [0.70 (0.69–0.72) μmol/L] (p < 0.001). Serum MDA level in Ta group [0.73 (0.70–1.05) μmol/L], T1 group [0.85 (0.80–1.12) μmol/L] and in T2–T4 group [0.91 (0.84–1.04) μmol/L] was significantly higher than the serum MDA level in control group [0.70 (0.69–0.72) μmol/L] (p < 0.01). MDA level in T1 and T2–T4 group was significantly higher than the MDA level in Ta group (p < 0.01). No significant difference was observed in MDA level between T1 and T2–T4 group (p = NS). A statistically significant positive correlation was found between tumor size and serum MDA level in patients with bladder cancer (rho = 0.254 p < 0.01).Conclusions. The results of the present study suggest that MDA serum level might play a significant role as a biomarker in the diagnosis of bladder cancer, as well as in the monitoring of its progression.


2018 ◽  
Vol 56 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Meral Çeliker ◽  
Mustafa Yavuz Selçuk ◽  
Serdar Olt

Abstract Objective. To investigate the relationship between sarcopenia and diabetic nephropathy. Methods. 56 diabetic patients without complications, 50 diabetic patients with nephropathy, 53 healthy controls included in this present study. Demographic characteristics such as sex, age, anthropometric measurements such as weight, body mass index [BMI], hip circumference, waist circumference and upper arm circumference were measured. Sarcopenia diagnosis was based on European Working Group on Sarcopenia in Older People [EWGSOP] criteria which consist of hand grip strength, 6-meter walking test and muscle mass. Results. The frequency of sarcopenia increased gradually from 15.1% in healthy control group to 21.4% in the diabetes group, and 34% in diabetic nephropathy group (X2 for trend, p = 0.029). The frequency of sarcopenia was similar in diabetes and diabetic nephropathy group. However, the frequency of sarcopenia was higher in diabetic nephropathy than healthy controls (OR = 2.89, CI [1.11-7.51] in logistic regression). Conclusion: In the present study, the prevalence of sarcopenia was higher in patients with diabetic nephropathy compared to healthy controls.


2021 ◽  
Vol 3 (3) ◽  
pp. 34-37
Author(s):  
Kavita Nagar ◽  
G.P. Sujatha ◽  
Ashok Lingappa

Background: Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder with areca nut being the main etiological agent. Increased risk of malignant potential of OSMF necessitates the early diagnosis of the condition. Superoxide dismutase (SOD) scavenges oxygenated free radicals and can be used as a potential biomarker for oral cancer detection. Objectives: The present study was conducted to estimate and compare salivary SOD levels in patients with OSMF and healthy controls and to compare its levels in different clinical and functional stages of OSMF. Methodology: The study group (Group 1) included 30 patients of OSMF, and the control group (Group 2) was formed by age and sex-matched healthy individuals. Salivary SOD levels were determined by Nitro Blue Tetrazolium (NBT) chloride method. The levels of salivary SOD were compared between the two groups and the data thus obtained was subjected to statistical analysis using independent sample t-test and one way Analysis of variance (ANOVA) test. Results: The mean salivary SOD in the study group was 0.583 IU/mL and 0.864 IU/mL in control group and the difference was found to be statistically significant. Thus, the patients with OSMF had significantly lower levels of salivary SOD compared to the controls. Conclusion: The decrease in the salivary SOD levels in patients with OSMF suggests the role of oxidative stress in the pathogenesis of OSMF and initiation and progression of carcinogenesis. Thus, it can be used as a prognostic marker for early detection of carcinoma in patients with OSMF and thereby, improving the quality of life patients.


2020 ◽  
Vol 14 (4) ◽  
pp. 178-182
Author(s):  
Vitor Pereira Xavier Grangeiro

Objective: We aimed to investigate the possible relationship between seminal parameters and cystatin C seminal levels in an infertility evaluation of chronic hemodialysis patients. Materials and Methods: This was a cross-sectional study, aged 18-60 years, in a group of 60 men undergoing hemodialysis (case) for more than 6 months, and a group of 15 healthy men (control) without clinical or laboratory signs of genitourinary tract infection. We performed a spermogram, hormonal profile, and assessment of leukocytes and cystatin levels in the semen. Results: The ages in the case and control were similar (p = 0.060).The seminal cystatin was significantly different between the case group and control group (41.16 ± 26.59 vs. 79.00 ± 05.68 mg/l, respectively, p < 0.001) and between normospermia and oligospermia (83.50 ± 02.40 vs. 30.34 ± 02.52 mg/l, respectively, p < 0.001). The mean seminal cystatin levels identified by the degrees of oligospermia (severe, moderate, and slim) were similar to each other (p > 0.05) and significantly different (p < 0.05) in relation to normospermia in the case group. The seminal cystatin levels positively correlated (p < 0.05) with sperm motility and sperm density. Conclusion: Seminal cystatin levels are associated with the numerical and motility changes evidenced in the spermogram and may be of help in the initial evaluation of clinical suspicion of sub-fertility and infertility.


Author(s):  
Kashish Narula ◽  
Narendra Kumar Dara ◽  
Shyam Lal Meena

Background: Thyroid hormones influence nearly all major metabolic pathways. Their most obvious and well-known action is the increase in basal energy expenditure obtained by acting on protein, carbohydrate and lipid metabolism. The lipid metabolism is more influenced by the thyroid hormone. Methods: A cross-sectional study was conducted on 100 patients with suspicion of thyroid disorders were taken as cases. One hundred patients with normal thyroid profile and no history of other chronic diseases were taken as control group. Results: The serum TC, TG and LDL levels in hypothyroid individuals (both overt and subclinical) were significantly higher than euthyroid subjects but the levels were comparable between hyperthyroid and euthyroid group. Conclusion: Dyslipidemias are associated with thyroid disorders, so biochemical screening for thyroid dysfunction in all dyslipidemic patients. Therefore, patients presenting with dyslipidemia are recommended for investigation to explore thyroid dysfunction. Keywords: Thyroid profile, Total cholesterol, Triglycerides and LDL


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