Diabetes, Metabolic Syndrome and Obesity (Jun 2020)
Evaluation of Urinary Neutrophil Gelatinase Associated Lipocalin and Kidney Injury Molecule-1 as Diagnostic Markers for Early Nephropathy in Patients with Type 2 Diabetes Mellitus
Abstract
Thuan Huynh Quang,1,2 Minh Pham Nguyet,3 Diep Pham Thao,4 Minh Hoang Thi,1,2 Lan Phuong Thi Dam,1,2 Hang Ho Thi,1,2 Anh Phan Van,1,2 Thang Can Luong,5 Mai Ngo Thi Tuyet,2 Quy Dang Duy,1,2 Binh Do Nhu,1,2 Thuan Nghiem Duc1,2 1Military Hospital 103, Ha Noi, Viet Nam; 2Vietnam Military Medical University, Ha Noi, Vietnam; 3 19-8 Hospital, Ministry of Public Security, Ha Noi, Vietnam; 4Viet Duc Hospital, Ha Noi, Viet Nam; 5Thanh Nhan Hospital, Ha Noi, Viet NamCorrespondence: Thuan Nghiem Duc Email [email protected]: The purpose of this study was evaluating the early diagnostic value of two specific tubular markers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in diabetes nephropathy.Patients and Methods: Cross-sectional study was carried in three groups of patients from 10/2017 to 10/2018 in Military Hospital 103. Group I included 30 healthy peoples with estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73 m2 and urine albumin creatinine ratio (uACR) < 30 mg/g. Group II included 30 type 2 diabetic patients having uACR < 30 mg/g, eGFR > 60 mL/min/1.73 m2. Group III included 30 type 2 diabetic patients having uACR > 30 mg/g, eGFR > 60 mL/min/1.73 m2.Results: Urine KIM-1 and NGAL increased progressively from control group (57.29 ± 25.91 pg/mL; 25.71 ± 13.69 ng/mL) to the group of diabetic patients with uACR < 30 mg/g (167.06 ± 44.01 pg/mL; 37.42 ± 10.89 ng/mL) and the group of diabetic patients with uACR ≥ 30 mg/g) (p < 0.05). There were moderate correlations between KIM-1 (r = 0.48, p < 0.05) and NGAL (r = 0.45, p < 0.05) with uACR. There was a mild correlation between KIM-1 and NGAL (r = 0.29, p < 0.05). KIM-1 and NGAL are the independent tests to detect diabetic nephropathy. The sensivity and specificity of KIM-1 with cut-off value of 174.95 pg/mL were 62.37% and 73.48%, respectively; the sensivity and specificity of NGAL with cut-off value of 35.2 ng/mL were 60.45% and 70.37%, respectively.Conclusion: KIM-1 and NGAL in urine are independent markers for early diagnostic diabetic nephropathy.Keywords: diabetic kidney disease, urine albumin creatinin ratio, albumin urine