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2016 ; 2016
(ä): 3102962
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Novel Tubular Biomarkers Predict Renal Progression in Type 2 Diabetes Mellitus: A
Prospective Cohort Study
#MMPMID27672664
Satirapoj B
; Aramsaowapak K
; Tangwonglert T
; Supasyndh O
J Diabetes Res
2016[]; 2016
(ä): 3102962
PMID27672664
show ga
Background. Tubulointerstitial injury is both a key feature of diabetic
nephropathy and an important predictor of renal dysfunction. Novel tubular
biomarkers related to renal injury in diabetic nephropathy could improve risk
stratification and prediction. Methods. A total of 303 type 2 diabetic patients
were followed up. The baseline urine values of cystatin-C to creatinine ratio
(UCCR), angiotensinogen to creatinine ratio (UANG), NGAL to creatinine ratio
(UNGAL), and KIM-1 to creatinine ratio (UKIM-1) were measured. The primary
outcome was a decline in estimated GFR of ?25% yearly from baseline. Results.
Urine tubular biomarkers of UCCR, UANG, UNGAL, and UKIM-1 were significantly
higher according to the degree of albuminuria and all were significantly higher
among patients with rapid decline in estimated GFR of ?25% yearly from baseline.
All biomarkers predicted primary outcomes with ROC for UCCR of 0.72; 95% CI
0.64-0.79, for UANG of 0.71; 95% CI 0.63-0.79, for UNGAL of 0.64; 95% CI
0.56-0.72, and for UKIM-1 of 0.71; 95% CI 0.63-0.79. Using multivariate Cox
regression analysis, the number of patients with rapid renal progression was
higher among those in the upper quartiles of all biomarkers than in those in the
lower quartiles. Conclusions. Type 2 diabetic patients with high levels of urine
tubular biomarkers had a more rapid decline in renal function.