Urinary N-acetyl-beta-d-glucosaminidase (NAG) with neutrophil gelatinase-associated lipocalin (NGAL) improves the diagnostic value for proximal tubule damage in diabetic kidney disease

Abstract

Screening for diabetic kidney disease (DKD) remains a challenge; however, there has been an ongoing research to investigate the diagnostic value of different biomarkers to identify DKD. The aim of this study was to assess the diagnostic value of both N-acetyl-beta-d-glucosaminidase (NAG) and neutrophil gelatinase-associated lipocalin (NGAL) in the progression of DKD. This cross-sectional case-control study included 92 type 2 diabetic patients with or without DKD. Urinary NAG and NGAL were measured to evaluate their diagnostic values as biochemical markers related to DKD. Both urinary NAG and NGAL levels were significantly higher among patients with DKD. In multiple linear regression analysis, NAG showed a positive significant association with NGAL in the three different adjusted models, while no significant correlation with fasting blood glucose, glycated hemoglobin, serum creatinine, estimated glomerular filtration rate, and albumin creatinine ratio were observed. The area under the curve for NGAL was 0.659 (p = 0.01) and 0.564 (p = 0.297) for NAG in DKD patients. This study demonstrates the association between urinary NAG and NGAL as a tubular damage marker for DKD although longitudinal studies are needed to evaluate its diagnostic value.

Investigating subtle kidney injury in primary hyperparathyroidism by means of sensitive and specific biomarkers

“…Besides acute kidney injury, clinical evidence derive from studies of a broad spectrum of conditions, such as diabetic kidney disease, lupus nephritis, CKD and IgA nephropathy . Urinary excretion of the molecule, expressed as both KIM‐1 and KIM‐1/creatinine ratio, was linked to kidney disease in type 1 and type 2 diabetes . We observed similar data in our cohort of PHPT women, where higher urine KIM‐1/uCr excretion was observed independently of baseline renal function.…”

“…The overall data showed that the assessment of a panel of the novel biomarkers is useful in the early detection of kidney injury, with high prognostic value . As far as endocrine disease, recent works have shown that the assessment of biomarkers of tubular damage could have diagnostic value in screening patients for diabetic kidney disease . Additionally, animal data have shown a direct association between specific biomarkers, mechanism of renal damage (ischaemic, toxic, inflammatory, etc) and the level of the nephron interested by injury .…”

“…Fewer data are reported in chronic disease . The overall data showed that the assessment of a panel of the novel biomarkers is useful in the early detection of kidney injury, with high prognostic value .…”

“…14 Fewer data are reported in chronic disease. 15,16 The overall data showed that the assessment of a panel of the novel biomarkers is useful in the early detection of kidney injury, with high prognostic value. 11,13 As far as endocrine disease, recent works have shown that the assessment of biomarkers of tubular damage could have diagnostic value in screening patients for diabetic kidney disease.…”

“…11,13 As far as endocrine disease, recent works have shown that the assessment of biomarkers of tubular damage could have diagnostic value in screening patients for diabetic kidney disease. 16 Additionally, animal data have shown a direct association between specific biomarkers, mechanism of renal damage (ischaemic, toxic, inflammatory, etc) and the level of the nephron interested by injury. 12 There has been no study so far assessing the utility of these biomarkers in patients with PHPT.…”