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

Abstract

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.

Eriodictyol inhibits high glucose‐induced extracellular matrix accumulation, oxidative stress, and inflammation in human glomerular mesangial cells

“…During the course of DN, the functional derangement and structural remodeling of the kidney are considered to be triggered by hyperglycemic injury and linked to changes in several cellular events and activation of signaling pathways (Uwaezuoke, ). There is substantial evidence supporting that ROS is dramatically increased in kidney exposed to HG condition (Checherita et al, ).…”

Specific expression network analysis of diabetic nephropathy kidney tissue revealed key methylated sites

“…For example, Yanyan Zhao et al identified two novel SNPs (rs10823108 in SIRT1 and rs17446614 in FOXO1) and two haplotypes within FOXO1 gene (defined by GT and GC) were susceptibility variants of DN and revealed SIRT1 and FOXO1 played a significant role in the development of DN in Chinese patients with type 2 diabetes (Zhao et al, ). Samuel N Uwaezuoke reported the role of novel biomarkers in predicting diabetic nephropathy, such as glomerular biomarkers, tubular biomarkers, biomarkers of inflammation, biomarkers of oxidative stress, and miscellaneous biomarkers, etc (Uwaezuoke, ). Patricia G Wilson et al demonstrated that renal apoB accumulation is conductive to the occurrence of DN and prevention of renal apoB accumulation by TGF‐β inhibition is protective against DN (Wilson, Thompson, Yoder, Charnigo, & Tannock, ).…”

Diabetic Nephropathy in Childhood: Predictive Tools and Preventive Strategies

“…Attempts have been made at classifying these biomarkers into major groups, although these groups overlap with one another. Representative groups include glomerular biomarkers; tubular biomarkers; biomarkers of inflammation; biomarkers of oxidative stress; and miscellaneous biomarkers [18]. Examples of each group of biomarkers include albumin, transferrin, laminin, immunoglobulin G, fibronectin, ceruloplasmin, type IV collagen, lipocalin-type prostaglandin synthase (L-PGDS), and glycosaminoglycans which make up the glomerular biomarkers; neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, kidney molecule injury 1 (KIM-1), liver-type fatty acid binding protein (L-FABP), N-acetyl-β-D-glucosaminidase (NAG) and α-1-microglobulin constitute the tubular biomarkers; tumor necrosis factor-α (TNF-α), interleukin-1β, interleukin-8, interleukin-18, monocyte chemoattractant protein-1 (MCP-1), eotaxin, orosomucoid, RANTES and granulocyte colonystimulating factor (G-CSF) represent the biomarkers of inflammation; 8-oxo-7,8-dihydro-2-deoxyguanosine (8oHdG) is a typical example of a biomarker of oxidative stress; nephrin, podocalyxin, advanced glycation end products (AGEs), vascular endothelial growth factor (VEGF), heart fatty-acid binding protein (H-FABP) and retinol-binding protein are listed as miscellaneous biomarkers.…”