Glomerular and Tubular Proteinuria in Type 1 (Insulin-Dependent) Diabetic Patients with and without Retinopathy

Martín, Paul; Tindall, H; Harvey, Jeremy N.; Handley, T; Chapman, C.; Davies, J. A.

doi:10.1177/000456329202900302

Cited by 11 publications

(5 citation statements)

References 22 publications

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“…67,68 Moreover, in macroalbuminuric diabetic patients, urinary transferrin excretion is positively correlated with UAE. [69][70][71] However, transferrinuria also occurs in primary glomerulonephritis, as well as systemic diseases which secondarily affect the glomerulus, thus underscoring its lack of specificity to DN. 72 Urinary IgG is another related biomarker.…”

Section: Glomerular Biomarkersmentioning

confidence: 99%

The role of novel biomarkers in predicting diabetic nephropathy: a review

Uwaezuoke

2017

IJNRD

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Diabetic nephropathy (DN) is one of the microvascular complications of the kidney arising commonly from type 1 diabetes mellitus (T1DM), and occasionally from type 2 diabetes mellitus (T2DM). Microalbuminuria serves as an early indicator of DN risk and a predictor of its progression as well as cardiovascular disease risk in both T1DM and T2DM. Although microalbuminuria remains the gold standard for early detection of DN, it is not a sufficiently accurate predictor of DN risk due to some limitations. Thus, there is a paradigm shift to novel biomarkers which would help to predict DN risk early enough and possibly prevent the occurrence of end-stage kidney disease. These new biomarkers have been broadly classified into glomerular biomarkers, tubular biomarkers, biomarkers of inflammation, biomarkers of oxidative stress, and miscellaneous biomarkers which also include podocyte biomarkers, some of which are also considered as tubular and glomerular biomarkers. Although they are potentially useful for the evaluation of DN, current data still preclude the routine clinical use of majority of them. However, their validation using high-quality and large longitudinal studies is of paramount importance, as well as the subsequent development of a biomarker panel which can reliably predict and evaluate this renal microvascular disease. This paper aims to review the predictive role of these biomarkers in the evaluation of DN.

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Section: Glomerular Biomarkersmentioning

confidence: 99%

The role of novel biomarkers in predicting diabetic nephropathy: a review

Uwaezuoke

2017

IJNRD

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“…Because diabetic patients are more likely to have transferrinuria than albuminuria [44, 49–54], and because the albumin/transferrin ratio was significantly smaller in normoalbuminuric and microalbuminuric compared to macroalbuminuric patients, urinary transferrin is considered to be a more sensitive marker of glomerular damage in diabetic patients [44, 50–54]. Furthermore, increased urinary transferrin excretion predicts the development of microalbuminuria in type 2 diabetic patients with normoalbuminuria [55, 56]; in patients that already developed albuminuria, the urinary transferrin excretion has a linear relationship with UAE [39, 40, 42–44, 47, 50, 53, 57–60]. …”

Section: Transferrinmentioning

confidence: 99%

Urinary Markers of Glomerular Injury in Diabetic Nephropathy

Cohen‐Bucay

Viswanathan

2012

International Journal of Nephrology

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Diabetic nephropathy, the leading cause of renal failure worldwide, affects approximately one-third of all people with diabetes. Microalbuminuria is considered the first sign and the best predictor of progression to renal failure and cardiovascular events. However, albuminuria has several limitations. Therefore, earlier, more sensitive and specific biomarkers with greater predictability are needed. The aim of this paper is to discuss the current literature on biomarkers of glomerular injury that have been implicated in diabetic kidney disease.

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“…Our results may thus be important. Other proteins were associated with renal lesions in nontransplanted populations: urinary transferrin excretion (linked to early glomerular change in diabetic patients [6,7]), nephrinuria (associated to glomerular damage in diabetic patients [8]), matrix metalloproteinase-9 and tissue inhibitor of metalloproteinases-1 (associated to renal scarring [9] or urinary cystatine C [10]). Whether these proteins play a role in renal function degradation is presently unknown in renal transplantation.…”

Section: Halimi Et Almentioning

confidence: 99%

Respective Predictive Role of Urinary Albumin Excretion and Nonalbumin Proteinuria on Graft Loss and Death in Renal Transplant Recipients

Halimi

Büchler

Al-Najjar

et al. 2007

American Journal of Transplantation

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Proteinuria is constituted by urinary albumin (UAE) and nonalbumin proteins (NAP). UAE was shown to predict ESRD and death. Whether NAP predicts graft or patient outcome is unknown in renal transplantation.We retrospectively analyzed the impact of UAE and NAP respectively on end-stage renal disease (ESRD) and death in 616 renal transplant recipients. In subjects with proteinuria <0.25 g/day, 76% of urine proteins were NAP; in those with >1 g/day, 44% of the urine proteins were NAP. Determinants of UAE and NAP were partly different: fasting glucose, body weight, donor cause of death and cyclosporine were significantly associated with NAP (but not UAE); panel reactive antibodies (PRA) and rapamycine were significantly associated with UAE (but not with NAP). NAP Massive proteinuria has been recognized as a risk factor for long-term graft loss (1,2). A recent study from our group indicated that low-grade proteinuria was a powerful independent predictor of long-term graft loss (3).Total proteinuria is made of various proportions of urine albumin (UAE) and nonalbumin proteinuria (NAP). Nonalbumin proteinuria includes several types of urinary proteins, and some of them were associated with renal damage or outcome in renal transplantation, including alpha-1 microglobulin, beta-2 macroglobulin and IgG (4). Other urinary proteins (cystatin C, transferrin, nephrin, matrix metalloproteinase-9 and tissue inhibitor of metalloproteinases-1,. . .) are biomarkers of renal damage in nontransplanted populations (5-10).Interestingly, it was recently demonstrated that UAE was an independent powerful risk factor for graft loss and death in renal transplant recipients (11). However, it is presently unknown whether NAP has any predictive value on graft loss or death, and therefore whether UAE and NAP provide different information on patient or renal outcome. The question about the respective prognostic value of UAE and NAP is not only academic: if only UAE (but not NAP) is an independent parameter associated to graft loss or death, screening for UAE may be discussed in all renal transplant recipients. Conversely, if NAP in addition to UAE also provides information on renal/patient outcome, then it would be interesting to identify the role of urinary proteins using proteomic analyses.To date, this type of analysis was not reported in the literature. We recently showed that UAE is a strong risk factor for graft loss and death; both UAE and total proteinuria were measured in each 616 patients included in this study (11), which allowed us to calculate NAP values in all patients. In the present analysis, we retrospectively analyzed and compared the respective predictive value of UAE and NAP in this population. Patients and Methods Study populationAs previously published (11), 616 patients were followed at our institution between 1998 and 2005: both total proteinuria and UAE were measured. Most patients received our institution's immunosuppressive regimen: induction therapy with antithymocyte globulin (Thymoglobulin ® , Sangstat, 2775

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Glomerular and Tubular Proteinuria in Type 1 (Insulin-Dependent) Diabetic Patients with and without Retinopathy

Cited by 11 publications

References 22 publications

The role of novel biomarkers in predicting diabetic nephropathy: a review

The role of novel biomarkers in predicting diabetic nephropathy: a review

Urinary Markers of Glomerular Injury in Diabetic Nephropathy

Respective Predictive Role of Urinary Albumin Excretion and Nonalbumin Proteinuria on Graft Loss and Death in Renal Transplant Recipients

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