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- Title
Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Kidney Injury Molecule 1 (KIM1) in patients with diabetic nephropathy: a cross-sectional study and the effects of lisinopril.
- Authors
Nielsen, S. E.; Schjoedt, K. J.; Astrup, A. S.; Tarnow, L.; Lajer, M.; Hansen, P. R.; Parving, H.-H.; Rossing, P.
- Abstract
Diabet. Med. 27, 1144–1150 (2010) Aims Our aim was to evaluate the markers of tubulointerstitial damage, neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule 1 (KIM1) in Type 1 diabetic patients with different levels of albuminuria and in control subjects. In addition, the effect of renoprotective treatment on urinary NGAL was evaluated in diabetic nephropathy. Methods This was a cross-sectional study in 58 normoalbuminuric (u-albumin < 30mg/24 h), 45 microalbuminuric (30–300 mg/24 h) and 45 macroalbuminuric (> 300 mg/24 h) Type 1 diabetic patients and 55 non-diabetic control subjects. Furthermore, in a second study, urine-NGAL was measured in a randomized cross-over study of 56 Type 1 diabetic patients with diabetic nephropathy treated with lisinopril 20, 40 and 60 mg daily. Results Urine-NGAL levels were [geometric mean (95% CI)]: control subjects 74 (52–104) (pg/mmol creatinine), normoalbuminuric 146 (97–221), microalbuminuric 222 (158–312) and macroalbuminuric group 261 (175–390). Urine-NGAL increased significantly from the normo- to the micro- and further to the macroalbuminuric group ( P < 0.05). Urine-NGAL was higher in normoalbuminuric vs. control subjects ( P < 0.01). Plasma-NGAL was significantly higher in the normoalbuminuric and macroalbuminuric groups than in the control group. Urine-KIM1 was higher in all diabetic groups than in the control group ( P < 0.001), with no difference between diabetic groups. During lisinopril treatment, urine-NGAL was reduced (95% CI) 17% (11–50) (not significant). Conclusions Urine-NGAL and urine-KIM1 (u-KIM1) are elevated in Type 1 diabetic patients, with or without albuminuria, indicating tubular damage at an early stage. Urine-NGAL increases significantly with increasing albuminuria. The ACE inhibitor lisinopril reduced urine-NGAL, but this was not statistically significant.
- Subjects
DIABETES complications; KIDNEY injuries; ALBUMINURIA; ANALYSIS of variance; ACE inhibitors; BIOMARKERS; CARRIER proteins; COMPUTER software; CONFIDENCE intervals; DIABETIC nephropathies; LONGITUDINAL method; REGRESSION analysis; STATISTICAL sampling; STATISTICAL hypothesis testing; STATISTICS; U-statistics; DATA analysis; CROSS-sectional method; BLIND experiment; SEVERITY of illness index; DRUG administration; DRUG dosage; PHARMACODYNAMICS; URINE; DRUG therapy
- Publication
Diabetic Medicine, 2010, Vol 27, Issue 10, p1144
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/j.1464-5491.2010.03083.x