Diagnostic Utility of Glomerular Injury Markers and Oxidative Stress Injury Markers in Various Stages of Diabetic Nephropathy

Abstract

Diabetes mellitus and its complications are associated with high mortality and morbidity Diabetic Asian Indians compared to westerners are highly prone to end organ complications The development of diabetic nephropathy demands an early detection aiming to decrease the incidence of end stage renal incidence Podocyte injury is an essential element in the diabetic renal disease occurrence and progression Hyperglycemia disrupts podocytes both structurally and functionally leading to excretion of podocyte markers which are normally present in the glomerular filtration barrier Glycation and oxidation injury form an essential element in the evolution of diabetic complications both microvascular and macrovascular This study was undertaken to find out whether podocyte markers urinary nephrin urinary podocin glycated albumin N Carboxymethyl lysine are better indicators of podocyte injury than albuminuria in patients with diabetic nephropathy Microalbumin was estimated by immunoturbidometry urinary nephrin urinary podocine glycated albumin and carboxy methyl lysine were measured by ELISA ANOVA and Tukey post hoc tests were one to compare the data between the groups Correlation studies were done The urinary nephrin was statistically significant with sensitivity of 92.5percent and specificity of 76 point 7 percent the cut off value of urinary nephrin was 97 point 5ng by mL Anthropometric and glycemic parameters significantly correlated positively with nephrin podocin microalbumin and urine ACR uACR and negatively with Glomerular Filtration Rate GFR The cutoff level of GA was 176 point 50 pmol by mL glycated albumin N carboxymethyl lysine in serum can serve as an early marker for diabetic nephropathy and its progression and severity The urinary podocin can serve as an early marker for diabetic nephropathy as well as a marker of disease progression and severity among the patients with Type 2 Diabetes newline