TY - JOUR
T1 - Tubular markers are associated with decline in kidney function in proteinuric type 2 diabetic patients
AU - Nielsen, Stine E.
AU - Reinhard, Henrik
AU - Zdunek, Dietmar
AU - Hess, Georg
AU - Gutiérrez, Orlando M.
AU - Wolf, Myles
AU - Parving, Hans Henrik
AU - Jacobsen, Peter K.
AU - Rossing, Peter
PY - 2012/7
Y1 - 2012/7
N2 - Our aim was to investigate u-NGAL, u-KIM1 and p-FGF23 and prediction of decline in kidney function in type 2 diabetic patients with proteinuria. Methods: We performed a follow-up study, follow-up median (range) 3.5 (1-5) years. At baseline u-NGAL, u-KIM1 and p-FGF23 (ELISA) was measured and patients were followed yearly with estimated(e)-GFR (MDRD) and u-albumin. Results: We included 177 patients (44 women), mean age (SD) 59 (9) years. eGFR 90 (24)ml/min/1.73m2 at baseline, u-albumin: median (interquartile range) 104 (39-238) mg/24h.Patients with levels of u-KIM1 in the highest quartile had a greater decline in eGFR than patients with the lowest quartile 6.0 (5.4) versus 3.2 (5.5)ml/min/1.73m2 per year (p=0.02). u-NGAL in the highest versus lowest quartile eGFR decline: 5.1 (4.7) and 2.8 (7.1)ml/min/1.73m2 per year (p=0.07).Higher values of u-NGAL and u-KIM1 were associated with enhanced decline in eGFR (R=0.16 and R=0.19, p<0.05), however not after adjustment for progression promoters. p-FGF23 was not predictive of decline in eGFR. Conclusion: Higher levels of markers of tubular damage are associated with a faster decline in eGFR. However, since this is not independent of known progression promoters, measurement of tubular markers does not give additional prognostic information.
AB - Our aim was to investigate u-NGAL, u-KIM1 and p-FGF23 and prediction of decline in kidney function in type 2 diabetic patients with proteinuria. Methods: We performed a follow-up study, follow-up median (range) 3.5 (1-5) years. At baseline u-NGAL, u-KIM1 and p-FGF23 (ELISA) was measured and patients were followed yearly with estimated(e)-GFR (MDRD) and u-albumin. Results: We included 177 patients (44 women), mean age (SD) 59 (9) years. eGFR 90 (24)ml/min/1.73m2 at baseline, u-albumin: median (interquartile range) 104 (39-238) mg/24h.Patients with levels of u-KIM1 in the highest quartile had a greater decline in eGFR than patients with the lowest quartile 6.0 (5.4) versus 3.2 (5.5)ml/min/1.73m2 per year (p=0.02). u-NGAL in the highest versus lowest quartile eGFR decline: 5.1 (4.7) and 2.8 (7.1)ml/min/1.73m2 per year (p=0.07).Higher values of u-NGAL and u-KIM1 were associated with enhanced decline in eGFR (R=0.16 and R=0.19, p<0.05), however not after adjustment for progression promoters. p-FGF23 was not predictive of decline in eGFR. Conclusion: Higher levels of markers of tubular damage are associated with a faster decline in eGFR. However, since this is not independent of known progression promoters, measurement of tubular markers does not give additional prognostic information.
KW - Diabetic nephropathy
KW - FGF23
KW - Tubules
KW - Type 2 diabetes
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U2 - 10.1016/j.diabres.2012.02.007
DO - 10.1016/j.diabres.2012.02.007
M3 - Article
C2 - 22402306
AN - SCOPUS:84864109785
SN - 0168-8227
VL - 97
SP - 71
EP - 76
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
IS - 1
ER -
