Prognostic evaluation model of diabetic nephropathy patients

Tu, Xiao; Luo, Na; Lv, Yiqi; Wang, Bijuan; Li, Yayu

doi:10.21037/apm-21-1454

Cited by 12 publications

(11 citation statements)

References 19 publications

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“…In the different stages of DKD, patients may demonstrate different clinical features consistent with the severity of the disease. In DKD progression, some blood and urine biomarkers might directly reflect the disease condition and were proven to be good predictors 26–30 . In the present study, our results showed that urinary NAG/CR levels exhibited remarkable difference between early and advanced DKD, and patient with advanced DKD was more likely to have higher levels of NAG/CR than that with early DKD.…”

Section: Discussionsupporting

confidence: 53%

Urinary N‐acetyl‐β‐d‐glucosaminidase‐creatine ratio is a valuable predictor for advanced diabetic kidney disease

Huang

Fei

Zhan

et al. 2022

Clinical Laboratory Analysis

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Background: Many biomarkers show high diagnostic values for diabetic kidney disease (DKD), but fewer studies focus on the predictive assessment of DKD progression by blood and urinary biomarkers.Aim: This study aims to find powerful risk predictors and identifying biomarkers in blood and urine for DKD progression.Methods: A total of 117 patients with type 2 DKD including early and advanced stages and their laboratory parameters were statistically assessed. A receiver operating characteristic (ROC) curve analysis was performed to evaluate the significance of discriminating between early and advanced DKD, and the predictive power for advanced DKD was analyzed by regression analysis and trisector grouping.Results: N-acetylβd-glucosaminidase-creatine (NAG/CR) level in advanced DKD was statistically higher than that in early DKD (p < 0.05), and there was a higher incidence of advanced DKD (72% vs. 56%) and high odds ratio (OR: 3.917, 95% CI: 1.579-10.011) of NAG/CR with ≥2.79 U/mmol compared with <2.79 U/mmol (p < 0.05).NAG/CR ratio also showed a higher area under the ROC curve of 0.727 (95% CI: 0.616-0.828, p = 0.010) with a high sensitivity (0.75) and a moderate specificity (0.66) when 1.93 U/mmol was set as the optimal cutoff value. The adjusted-multivariable analysis revealed that NAG/CR had an OR of 1.021 (95% CI: 1.024-1.038) and 2.223 (95% CI: 1.231-4.463) based on a continuous and categorical variable, respectively, for risk of advanced DKD. Moreover, the prevalence of advanced DKD exhibited an increasing tendency by an increment of the trisector of NAG/CR. How to cite this article: Huang Q, Fei X, Zhan H, et al. Urinary N-acetylβd-glucosaminidase-creatine ratio is a valuable predictor for advanced diabetic kidney disease.

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Section: Discussionsupporting

confidence: 53%

Urinary N‐acetyl‐β‐d‐glucosaminidase‐creatine ratio is a valuable predictor for advanced diabetic kidney disease

Huang

Fei

Zhan

et al. 2022

Clinical Laboratory Analysis

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“…DKD is the key risk factor for end-stage kidney disease (ESKD) and diabetic mortality. Recently, as the prevalence of DKD grows continuously, the number of patients with ESKD caused by DKD is increasing, with an irreversible endpoint, and of note is that the 3-year and 5-year renal survival rates were 74.5% and 22.6%, respectively, in a small-scale clinical prognostic evaluation study in China [ 3 ]. Currently, clinical therapy and nutrition strategy mainly focus on blood glucose control, blood pressure control, lipid control, and diet management [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Metabolic Homeostasis of Amino Acids and Diabetic Kidney Disease

Luo-kun

Zhang

et al. 2022

Nutrients

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Diabetic kidney disease (DKD) occurs in 25–40% of patients with diabetes. Individuals with DKD are at a significant risk of progression to end-stage kidney disease morbidity and mortality. At present, although renal function-decline can be retarded by intensive glucose lowering and strict blood pressure control, these current treatments have shown no beneficial impact on preventing progression to kidney failure. Recently, in addition to control of blood sugar and pressure, a dietary approach has been recommended for management of DKD. Amino acids (AAs) are both biomarkers and causal factors of DKD progression. AA homeostasis contributes to renal hemodynamic response and glomerular hyperfiltration alteration in diabetic patients. This review discusses the links between progressive kidney dysfunction and the metabolic homeostasis of histidine, tryptophan, methionine, glutamine, tyrosine, and branched-chain AAs. In addition, we emphasize the regulation effects of special metabolites on DKD progression, with a focus on causality and potential mechanisms. This paper may offer an optimized protein diet strategy with concomitant management of AA homeostasis to reduce the risks of DKD in a setting of hyperglycemia.

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“…In development and progression of T2D and DKD, some basic biomarkers in blood and urine may directly demonstrate the status of disease, and are sure to be good predictors [27][28][29][30]. In this study, when using plasma FIB and urinary α1-MG/CR as well as their combination as predictive factors, their optimal cut-off points would be needed to categorize patients with and without the risk.…”

Section: Discussionmentioning

confidence: 98%

Predictive significance of joint plasma fibrinogen and urinary alpha-1 microglobulin-creatinine ratio in patients with diabetic kidney disease

Pan¹,

et al. 2022

PLoS ONE

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Background Although many biomarkers have high diagnostic and predictive power for diabetic kidney disease (DKD), less studies were performed for the predictive assessment in DKD and its progression with combined blood and urinary biomarkers. This study aims to explore the predictive significance of joint plasma fibrinogen (FIB) concentration and urinary alpha-1 microglobulin-creatinine (α1-MG/CR) ratio in DKD. Methods A total of 234 patients with type 2 diabetes were enrolled, and their clinical and laboratory data were retrospectively assessed. A ROC curve analysis was performed to evaluate the power of plasma FIB and urinary α1-MG/CR ratio for identifying DKD and advanced DKD, respectively. The predictive power for DKD and advanced DKD was analyzed by regression analysis. Results Plasma FIB and urinary α1-MG/CR levels were higher in patients with DKD than with pure T2D (p<0.001). The multivariate-adjusted odds ratios (ORs) were 5.047 (95%CI: 2.276–10.720) and 2.192 (95%CI: 1.539–3.122) (p<0.001) for FIB and α1-MG/CR as continuous variables for DKD prediction, respectively. The optimal cut-off values were 3.21 g/L and 2.11mg/mmol for identifying DKD, and 5.58 g/L and 11.07 mg/mmol for advanced DKD from ROC curves. At these cut-off values, the sensitivity and specificity of joint FIB and α1-MG/CR were 0.95 and 0.92 for identifying DKD, and 0.62 and 0.67 for identifying advanced DKD, respectively. The area under curve was 0.972 (95%CI: 0.948–0.995) (p<0.001) and 0.611, 95%CI: 0.488–0.734) (p>0.05). The multivariate-adjusted ORs for joint FIB and α1-MG/CR at the cut-off values were 214.500 (95%CI: 58.054–792.536) and 3.252 (95%CI: 1.040–10.175) (p<0.05), respectively. Conclusion The present study suggests that joint plasma FIB concentration and urinary α1-MG/CR ratio can be used as a powerful predictor for general DKD, but it is less predictive for advanced DKD.

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Prognostic evaluation model of diabetic nephropathy patients

Cited by 12 publications

References 19 publications

Urinary N‐acetyl‐β‐d‐glucosaminidase‐creatine ratio is a valuable predictor for advanced diabetic kidney disease

Urinary N‐acetyl‐β‐d‐glucosaminidase‐creatine ratio is a valuable predictor for advanced diabetic kidney disease

Metabolic Homeostasis of Amino Acids and Diabetic Kidney Disease

Predictive significance of joint plasma fibrinogen and urinary alpha-1 microglobulin-creatinine ratio in patients with diabetic kidney disease

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