Novel Tubular Biomarkers Predict Renal Progression in Type 2 Diabetes Mellitus: A Prospective Cohort Study

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 pati...

Full description

Saved in:
Bibliographic Details
Main Authors: Bancha Satirapoj, Kasemsan Aramsaowapak, Theerasak Tangwonglert, Ouppatham Supasyndh
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2016/3102962
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832568327935885312
author Bancha Satirapoj
Kasemsan Aramsaowapak
Theerasak Tangwonglert
Ouppatham Supasyndh
author_facet Bancha Satirapoj
Kasemsan Aramsaowapak
Theerasak Tangwonglert
Ouppatham Supasyndh
author_sort Bancha Satirapoj
collection DOAJ
description 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.
format Article
id doaj-art-f3bab0d42982446bb5eeb37078646e4c
institution Kabale University
issn 2314-6745
2314-6753
language English
publishDate 2016-01-01
publisher Wiley
record_format Article
series Journal of Diabetes Research
spelling doaj-art-f3bab0d42982446bb5eeb37078646e4c2025-02-03T00:59:18ZengWileyJournal of Diabetes Research2314-67452314-67532016-01-01201610.1155/2016/31029623102962Novel Tubular Biomarkers Predict Renal Progression in Type 2 Diabetes Mellitus: A Prospective Cohort StudyBancha Satirapoj0Kasemsan Aramsaowapak1Theerasak Tangwonglert2Ouppatham Supasyndh3Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, ThailandDivision of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, ThailandDivision of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, ThailandDivision of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, ThailandBackground. 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.http://dx.doi.org/10.1155/2016/3102962
spellingShingle Bancha Satirapoj
Kasemsan Aramsaowapak
Theerasak Tangwonglert
Ouppatham Supasyndh
Novel Tubular Biomarkers Predict Renal Progression in Type 2 Diabetes Mellitus: A Prospective Cohort Study
Journal of Diabetes Research
title Novel Tubular Biomarkers Predict Renal Progression in Type 2 Diabetes Mellitus: A Prospective Cohort Study
title_full Novel Tubular Biomarkers Predict Renal Progression in Type 2 Diabetes Mellitus: A Prospective Cohort Study
title_fullStr Novel Tubular Biomarkers Predict Renal Progression in Type 2 Diabetes Mellitus: A Prospective Cohort Study
title_full_unstemmed Novel Tubular Biomarkers Predict Renal Progression in Type 2 Diabetes Mellitus: A Prospective Cohort Study
title_short Novel Tubular Biomarkers Predict Renal Progression in Type 2 Diabetes Mellitus: A Prospective Cohort Study
title_sort novel tubular biomarkers predict renal progression in type 2 diabetes mellitus a prospective cohort study
url http://dx.doi.org/10.1155/2016/3102962
work_keys_str_mv AT banchasatirapoj noveltubularbiomarkerspredictrenalprogressionintype2diabetesmellitusaprospectivecohortstudy
AT kasemsanaramsaowapak noveltubularbiomarkerspredictrenalprogressionintype2diabetesmellitusaprospectivecohortstudy
AT theerasaktangwonglert noveltubularbiomarkerspredictrenalprogressionintype2diabetesmellitusaprospectivecohortstudy
AT ouppathamsupasyndh noveltubularbiomarkerspredictrenalprogressionintype2diabetesmellitusaprospectivecohortstudy