Urinary Markers of Glomerular Injury in Diabetic Nephropathy

Abstract

<jats:p>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.</jats:p>

Assessment of the diagnostic value of different biomarkers in relation to various stages of diabetic nephropathy in type 2 diabetic patients

“…All the biomarkers evaluated in this study were either markers of renal injury including markers of glomerular or tubular damage or markers of inflammation including pro-inflammatory cytokines, adhesion molecules, adipokines and Chemokines 10, 11 .…”

The effect of renal hyperfiltration on urinary inflammatory cytokines/chemokines in patients with uncomplicated type 1 diabetes mellitus

“…Urine cytokines/chemokines may therefore act as future therapeutic targets for novel or existing medications and can be used by clinicians to monitor treatment failure or success. The identification of new biomarkers of renal disease initiation and progression is critical due to the widely recognised limitations of albuminuria as a clinical outcome measure [39].…”

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

“…The author acknowledges the invaluable information obtained from the studies by Arora and Singh, 17 Cohen-Bucay andViswanathan, 43 and Gluhovschi et al 56 during the preparation of the manuscript.…”

“…Normoalbuminuria refers to UAE of <30 mg/day or 20 μg/min, while microalbuminuria and macroalbuminuria refer to UAE of 30-300 mg/day or 20-200 μg/min, and >300 mg/day or 200 μg/min, respectively. 43 Because baseline albuminuria is the strongest predictor of ESKD and cardiovascular morbidity in T2DM, 44,45 the American Diabetes Association has recommended screening with yearly UAE in all patients with T2DM, commencing at the time of diagnosis. 46 Remarkably, microalbuminuria constitutes a risk factor for chronic kidney disease and ESKD, and also serves as a powerful predictor of cardiovascular morbidity and mortality in diabetic subjects.…”