Tubular markers are associated with decline in kidney function in proteinuric type 2 diabetic patients

Stine E. Nielsen*, Henrik Reinhard, Dietmar Zdunek, Georg Hess, Orlando M. Gutiérrez, Myles Wolf, Hans Henrik Parving, Peter K. Jacobsen, Peter Rossing

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

53 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)71-76
Number of pages6
JournalDiabetes Research and Clinical Practice
Volume97
Issue number1
DOIs
StatePublished - Jul 1 2012

Keywords

  • Diabetic nephropathy
  • FGF23
  • Tubules
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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