Noninvasive method of differentiating diabetic nephropathy and nondiabetic renal disease using serum bone morphogenetic protein-7 and transforming growth factor-beta 1 levels in patients with type-2 diabetes mellitus

Abstract

Diabetic nephropathy (DN), one of the major complications of diabetes mellitus, is diagnosed by the presence of pedal edema, 24-h proteinuria >300 mg/day, and retinopathy. However, in view of variable clinical presentations and deviation from the above-said clinical features, it has become difficult to diagnose DN or the presence of nondiabetic renal disease (NDRD). Many biomarkers have been identified which could predict the progression of DN. Despite such advancement in science, it is still difficult to differentiate between DN and NDRD. Diabetes is a state of chronic inflammation. Among the pro-inflammatory cytokines, it has been shown that transforming growth factor-beta (TGF-β) and bone morphogenetic protein-7 (BMP-7) play a key role in the development and progression of DN. We assessed whether the levels of serum BMP-7 and TGF-β can help differentiate between DN and NDRD, thus serving as surrogate markers of DN.