Assessment of Serum and Urine Neurophil Gelatinase- Associated Lipocalin (s-NGAL and u-NGAL) Level as a Predictive Factor of Disease Progression in Diabetic Nephropathy in Type 2 DM

2021 ◽  
Vol 15 (4) ◽  
Author(s):  
Atefeh Amouzegar ◽  
Laily Najafi ◽  
Shahin Keshtkar Rajabi ◽  
Sondos Pirsaheb ◽  
Hossein Keyvani ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Chung-Ze Wu ◽  
Li-Chien Chang ◽  
Yuh-Feng Lin ◽  
Yi-Jen Hung ◽  
Dee Pei ◽  
...  

In cell model, we discovered the association between chaperonin-containing t-complex polypeptide 1 subunitβ(TCP-1β) and early diabetic nephropathy (DN). In this study, we further explored the relationships between TCP-1βand type 2 diabetic mellitus (DM). To mimic the clinical hyperfiltration state, a type 2 DM mice model was established by feeding a high-fat diet in combination with treatment of streptozotocin and nicotinamide. Blood and urine were collected to determine creatinine clearance (Ccr), and kidney tissues were harvested for evaluation of TCP-1βexpression by immunohistochemistry and Western blot. Meanwhile, clinical subjects of healthy controls and type 2 DM were recruited to strengthen the evidence with urine TCP-1β. Results showed thatCcrand the expression of TCP-1βin kidney were significantly higher one week after hyperglycemia development, suggesting that the hyperfiltration state was successfully established in the mice model. TCP-1βwas expressed predominantly on renal tubules. By using the estimated glomerular filtration rate to index progression in clinical investigation, urine TCP-1βlevel was associated with the hyperfiltration phase in type 2 DM patients. Conclusively, we confirmed that TCP-1βis a possible biomarker for early nephropathy of type 2 DM, but further mechanistic study to elucidate its cause and pathway is needed.



Author(s):  
Asriyani Azikin ◽  
Fitriani Mangarengi ◽  
Uleng Bahrun

Diabetic nephropathy is one of the fairly severe Diabetes Mellitus (DM) complications and the main cause of renal failure that can result in mortality. Hyperglycemia in DM induces kidney injury that may result in hemodynamic and metabolic alterations, endothelial dysfunction and inflammatory cells activation. A persistent and continuous inflammation is observed in diabetic nephropathy. One of the inflammation process progression indicators is Neutrophil-Lymphocyte Ratio (NLR). To find out the relationship between NLR and decreased Glomerular Filtration Rate (GFR) in diabetic nephropathy. This study was an observational study with a retrospective approach. This study was conducted in Clinical Pathology Laboratory Installation and Medical Record Installation of Dr. Wahidin Sudirohusodo Makassar Hospital by collecting the patient’s data during February 2015 to February 2016. Patients that were diagnosed as type 2 DM without diabetic nephropathy complication were taken as control and those diagnosed as type 2 DM with diabetic nephropathy were treated as study subjects. One hundred and thirteen (113) samples met the inclusion criteria, consisting of 73 diabetic nephropathy patients with Chronic Kidney Disease (CKD) 13 diabetic nephropathy patients without CKD and 27 type 2 DM patients without diabetic nephropathy complication. Patients consisted of 57 males (50.4%) and 56 females (49,6%). Neutrophil-lymphocyte ratio and GFR values in the group of diabetic nephropathy without CKD were 2.03±0.68 and 85.38±24.63, respectively. Whereas, the NLR and GFR values in control group were 1.74±0.54 and 90.03±28.60, respectively. In the group of diabetic nephropathy with CKD, NLR value increased by 3.19±1.83 and GFR decrease by 30.54±16.45. Spearman test indicated a significant relationship between NLR increase and decreased GFR (r = -0.635, p=0.00). There is a significant relationship between  NLR increase and decreased GFR in patients with diabetic nephropathy. 



QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Salah El-Din A Shelbaya ◽  
Hanan M Ali ◽  
Rana H Ibrahim ◽  
Nourhan Safwat Sawirs

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.



2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii478-iii479
Author(s):  
Gema Maria Fernandez Juarez ◽  
Javier Villacorta Pérez ◽  
Ernesto Martinez Martinez ◽  
Victoria Cachofeiro ◽  
Ana Tato ◽  
...  


2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Somsak Thojampa

Abstract Background/Purpose: Type 2 diabetes mellitus (DM) is increasingly becoming common in developing countries including Thailand. Uncontrolled hyperglycemia can lead to progression of severe complications for persons with DM which include diabetic nephropathy and can, later on, lead to kidney failure. Self-management support and participation of social groups, specifically the family of the patient, can help people with DM in controlling the complications of their disease from progressing; in this case, the advancement of diabetic nephropathy. The aim of this research is to develop a program and determine if self-management support with the participation of the family members will have an effect in delaying the progress of diabetic nephropathy in adults with type 2 DM. Theoretical Framework: Self-management based on social cognitive and self-regulation theories were used in this study to set a framework which utilizes social support from the family and self-efficacy of patients in implementing self-management activities. Methods: This is a quasi-experimental research. The sample consisted of 50 Thai adults with type 2 DM, 25 for the control group and 25 for the experimental group. The participants in the experimental group attended a self-management support and family participation enhancing the program for 8 weeks. The interventions included a video presentation, manual, and health education with a family member in a focus group. Data were collected before attending the program and evaluated on the 8th and 12 weeks after the program. The instruments used for the data collection were (1) Self-Management Activity Questionnaire (SMAQ), (2) Self- Efficacy Questionnaire (SEQ). The data collected for clinical outcome used the automatic physiological measures: Systolic and Diastolic blood pressure, Hemoglobin A1c (HbA1c), serum creatinine (SCr) and estimated glomerular filtration rate (eGFR).  Data were analyzed using descriptive statistics, Independent t-test and Paired t-test and repeated measurement ANOVA. Results: The mean scores of the self-management activity and self-efficacy of the experimental group were significantly higher, their clinical outcomes for blood pressure, SCr and HbA1C levels were significantly lower, and eGFR results were significantly higher after attending the self-management support and family participation enhancing the program. Conclusions and Implications: The findings of this study indicate that the self-management and family participation enhancing program promote and support health behavior change and leads to better control of the delayed progression of diabetic nephropathy in Thai adults with type 2 DM. This can be applied by health care professionals in health care centers as a supplement to their usual care in dealing with persons with type 2 DM.



Nephrology ◽  
2005 ◽  
Vol 10 (s2) ◽  
pp. S32-S36 ◽  
Author(s):  
SANG-HO LEE ◽  
TAE WON LEE ◽  
CHUN-GYOO IHM ◽  
MYUNG JAE KIM ◽  
JEOUNG-TAEK WOO ◽  
...  


2019 ◽  
pp. 105-110
Author(s):  
O. M. Chernatska ◽  
T. S. Mazur ◽  
N. V. Demikhova ◽  
O. M. Vlasenko ◽  
T. M. Rudenko ◽  
...  

The actual problem of internal medicine is the managemen of patients with comorbid pathology. Arterial hypertension (AH) is determined in about quarter of the population in the world. Moreover, the coexistence of AH and type 2 diabetes mellitus (DM) connected with the increased risk of cardiovascular complications (CVC) compared with patients with AH. In principle dyslipidemia is the common link between AH and type 2 DM, which need the correction. No doubt that reduction of atherogenic and increase of anti atherogenic lipoproteins is necessary for persons with comorbid pathology. The objective of our study was the assessment of atorvastatin treatment in patients with AH, diabetic nephropathy and type 2 DM. We obtained 96 patients with AH, diabetic nephropathy and type 2 DM (І group), 25 persons with AH (ІІ group), 15 conditionally healthy individuals. Persons had CVC in the past. For patients from the І and ІІ group CVC were defined accordingly (4,97 ± 0,20) years and (4,10 ± 0,05) years ago (P = 0,0291). The duration of AH is (8,1 ± 0,2) years for the І group and (8,90 ± 0,13) years for the ІІ group. The levels of lipid profile spectrum were determined according to the methods of W. T. Friedewald. The results of investigation were analyzed with the help of Microsoft Excel 2016. Correction of lipid profile spectrum is the important part of multipurpose treatment for persons with coexistent pathology. All patients were treated by atorvastatin (10−40 mg/day) during 6 months in a complex therapy. The target levels of general cholesterol during 6 months were presented in 30 persons (31.91 %), low density lipoproteids – in 10 persons (10.64 %), high density lipoproteids – in 26 persons (27.66 %), triglycerides – in 34 persons (36.17 %) among patients with AH, diabetic nephropathy and type 2 DM. In conclusion, it is advisable to prescribe atorvastatin (10–40 mg/day) for correction of dyslipidemia, reduction of proatherogenic orientation, prevention of atherosclerotic process manifestation and cardiovascular complications in patients with AH with diabetic nephropathy and type 2 diabetes mellitus.



2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Sewnet Adem Kebede ◽  
Biruk Shalmeno Tusa ◽  
Adisu Birhanu Weldesenbet ◽  
Zemenu Tadesse Tessema ◽  
Tadesse Awoke Ayele

Background. Although the rate of diabetic nephropathy which is the leading cause of end-stage renal disease (ESRD) continues to rise, there is limited information about the problem. This study aimed to assess the incidence and predictors of diabetic nephropathy among type 2 DM patients. Methods. Institution-based retrospective follow-up study was conducted at UGCSH with 462 newly diagnosed type 2 DM patients from January 2001 to February 2016, and the data were collected by reviewing their records. The Schoenfeld residuals test was used to check proportional hazard assumption. The best model was selected by using Akaike information criteria (AIC). Hazard ratios (HR) with its respective 95% confidence interval were reported to show significance and strength of association. Results. The incidence rate of diabetic nephropathy was 14 (95% CI 10.8–17.7) cases per 10,000 patient-month observation. In addition, 63 (13.6%) DM patients developed diabetic nephropathy. The median time to develop diabetic nephropathy was 94.9 months with interquartile range (IOR) of (64.1–127.4) months. Type 2 DM patients who had coronary heart disease (AHR = 2.69, 95% CI 1.42–5.13) and anemia (AHR = 1.94, 95% CI 0.97–3.87) were at higher hazard for developing diabetic nephropathy. Besides this, having a long duration (>10 years) (AHR = 0.24, 95% CI 0.11–0.56) and being female (AHR = 0.44, 95% CI 0.26–0.73) was found to be protective against diabetic nephropathy. Conclusion. The incidence of diabetic nephropathy among type 2 diabetes patients remains a significant public health problem. Duration of diabetes >10 years and female sex reduced the risk of diabetic nephropathy. Coronary heart disease and anemia increased the risk of diabetic nephropathy among type 2 DM patients. In light of these findings, early screening for diabetes complication is needed, and health professionals should give targeted intervention for type 2 DM patients with coronary heart disease comorbidity and anemia.



Author(s):  
Emmy Wahyuni ◽  
Imam Budiwiyono

Diabetic Nephropathy is one of several chronic complication of type 2 DM that could lead to end stage renal disease (ESRD). In type2 DM patients, about 85% of ESRD caused by diabetic nephropathy. Persistent microalbuminuria can be predictor for nephropathy. Earlydetection of microalbuminuria could be useful in improving an aggressive treatment to avoid ESRD and other macrovasculer disorder intype 2 DM patients. The purpose of this study was to describe the microalbuminuria profile in type 2 DM patients. A cross sectional studywas taken on 21 type 2 DM patients. Data were analyzed by descriptive analyzed (distribution, frequency, mean, standard deviation, ttest). P value < 0.05 was considered significant. This study reveals that frequency microalbuminuria was 78.9%. There was no differentage between microalbuminuria and normoalbuminuria. Duration of diabetes in microalbuminuria patients were more longer. Themean time is 45.3 (41) months and normoalbuminuria 36(16) months. The systolic and diastolic pressure in microlabuminuria washigher than normoalbuminuria. The body mass index between microalbuminurian and normoalbuminuria (P < 0.05) was significantlydifferent. In patient with microalbuminuria the mean of HbA1c value was 7.9(2.5) and in normoalbuminuria patient it was 9(1.8).There were no significant different of lipid profile between both samples. In this study was only found significantly different of body massindex between microalbuminuria and normoalbuminuria patients.





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