DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20210443

Diabetic nephropathy: early markers for monitoring and prevention

Vijayashree S. Gokhale, Kshithija R. Sajjan, Rupesh Parati, Keyuri Mehta

Abstract


Background: Type 2 diabetes, with its complications is perpetually on the rise more so in India .Diabetic Nephropathy progresses silently, and manifests at a stage where, patient can be offered only renal replacement. This study was undertaken to detect early markers of Diabetic Nephropathy. Aims and objective of the study was to study early nephropathy by UACR (urinary albumin/creatinine ratio), RFT (renal function test) and e-GFR in Type 2 diabetic patients of more than 2 years duration, with and without hypertension.

Methods: A hospital based cross-sectional observational study, of 100 patients, 18-60 years of age, of type 2 Diabetes of 2 year duration and above, of which 50 were only diabetic and 50 had diabetes and hypertension. Patients who had an established renal disease were excluded from study.

Results: Our study of 100 patients, 18-60 years of age, had 23 male and 77 female patients. Maximum patients were in age group 41-50 years, and 52% had diabetes of 2-4 years duration. Of the renal parameters studied, BUN was normal in 72% and S. Creatinine normal in 67%. UACR was normal in only 38%, and e-GFR was normal in 49%.

Conclusions: In our study age and sex, duration of Diabetes and HbA1c did not have any bearing on renal parameters. UACR followed by e-GFR, were deranged early. UACR was more deranged in diabetics with hypertension.

 


Keywords


Diabetic nephropathy, e-GFR, Hypertension, UACR

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References


Gross JL, Azevedo MJ, Silveiro SP. Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care. 2005;28(1):164-76.

Granier C, Makni K, Laurence M. Gene and protein markers of diabetic nephropathy. Nephrology Dialysis Transplant. 2008;23(3):792-9.

Nielsen SE. Sugaya T, Tarnow L, Lajer M. Tubular and glomerular injury in diabetes and the impact of ACE inhibition. Diabetes Care. 2009;32(9):1684-8.

Haque N, Debnath BC, Ibrahim M. Association of HbA1c with urinary ACR and eGFR in Type-2 Diabetes Mellitus. Pulse. 2011;5(1):6-11.

Vupputuri S, Nichols GA, Lau H. Risk of progression of nephropathy in a population-based sample with type 2 diabetes. Diabetes Res Clin Pract. 2011;91(2):246-52.

Klein J. Biomarkers that predict diabetic nephropathy: the long road from finding targets to clinical use diabetes. 2012;61(12):3072-3.

Manikowski ST, Mohamed G. Atta diabetic kidney disease: pathophysiology and therapeutic targets. J Diab Res. 2015;697010.

Hahr AJ, Molitch ME. Management of diabetes mellitus in patients with chronic kidney disease. Clinical Diab Endocrinol. 2015;1:2.

Fiseha T. Urinary biomarkers for early diabetic nephropathy in type 2 diabetic patients. Biomark Res. 2015;3:16.

Looker HC, Colombo M, Sibylle H. Biomarkers of rapid chronic kidney disease progression in type 2 Diabetes. Clinical Investigation. 2015;88(4):888-96.

Sydney CW, Gary CW, Chan L, Kar N. Recent advances in managing and understanding diabetic nephropathy. Faculty Rev. 2016;5:1000.

Chawla A, Chawla R, Jaggi S. Microvasular and macrovascular complications in diabetes mellitus: distinct or continuum? Indian J Endocrinol Metab. 2016;20(4):546-51.

Gluhovschi C, Gluhovschi G, Petrica L, Timar R. Urinary biomarkers in the assessment of early diabetic nephropathy. Diabetes. 2016:4626125.

Alicic R, Rooney MT, Katherine R. Tuttle diabetic kidney disease challenges, progress, and possibilities. Clin J Am Soc Nephrol. 2017;12:2032-45.

Al-Rubeaan K, Siddiqui K, Al-Ghonaim M, Youssef AM. Assessment of the diagnostic value of different biomarkers in relation to various stages of diabetic nephropathy in type 2 diabetic patients. Scientific Reports. 2017;7:2684.

Marketou NP, Gantenbein CK, Marketos N, Chrousos GP. Biomarkers of diabetic nephropathy A 2017 update. Journal Critical Rev. 2017;54:5.

Uwaezuoke SN. The role of novel biomarkers in predicting diabetic nephropathy: a review. Int J Nephrol Renovasc Dis. 2017;10:221-31.

Idowu AA, Ajose AO, Adedeji AT. Microalbuminuria, other markers of nephropathy and biochemical derangementsin type 2 diabetes mellitus: relationships and determinants. Ghana Med J. 2017;51(2):56-63.

Satirapoj B. Tubulointerstitial Biomarkers for diabetic nephropathy. J Diabetes Res. 2018;2018:2852398.

Colhoun HM, Loredana M. Marcovecchio 2 Biomarkers of diabetic kidney disease. Diabetologia. 2018;61(5):996-1011.

Norris KC, Smoyer KE, Rolland C. Albuminuria, serum creatinine, and estimated glomerular filtration rate as predictors of cardio-renal outcomes in patients with type 2 diabetes mellitus and kidney disease: a systematic literature review. BMC Nephrol. 2018;19(1):36.

Kopel J, Hernandez CP, Nugent K. Evolving spectrum of diabetic nephropathy. World J Diabetes. 2019;10(5):269-79.

Zhang D, Ye S, Pan T. The role of serum and urinary biomarkers in the diagnosis of early diabetic nephropathy in patients with type 2 diabete. Peer J. 2019;7:e7079.

Damaso EO, Damaso NO, Esparragon FR, Payan J. Asymmetric (ADMA) and symmetric (SDMA) dimethylarginines in chronic kidney disease: a clinical approach. Int J Mol Sci. 2019;20(15):3668.

Lo KB, Gul F, Ram P, Kluger AY, Tecson KM. The Effects of SGLT2 inhibitors on cardiovascular and renal outcomes in diabetic patients: a systematic review and meta-analysis. Cardiorenal Med. 2020;10:1-10.

Xie X, Peng Z. Association of urine albumin/creatinine ratio below 30 mg/g and left ventricular hypertrophy in patients with type 2 diabetes. Bio Med Res Int. 2020;5240153.

Bhaisare SD, Rao AK, Jog AS. Clinical study of urine albumin creatinine ratio as an earlier predictor of diabetic nephropathy. J Evolution Med Dent Sci. 2020;9(09):598-602.