Assessment of Urinary Podocin Level as an Early Indicator in Diabetic Nephropathy

Abstract

Background: Diabetic nephropathy one of the leading causes of end stage renal disease in which podocytes damage play a vital role. It will be interesting to recognize podocyturia as a first noninvasive marker of subclinical early renal damage. The current study was aimed to assess the Urinary podocin level (podocyte-specific protein detected in urine using antipodocin antibody ELISA kit) as an early indicator for the glomerular lesion in patients with type 2 diabetes mellitus. Methods: This study included 45 clinically stable type 2 diabetic patients with glomerular filtration rate (GFR) (>60 ml/min/1.73m2) and excluded patients with fever, urinary tract infection, uncontrolled hypertension, congestive heart failure or malignancy collected from Zagazig University Hospitals and Air force Hospital. In addition to 15 apparently healthy volunteers matched in age and sex as a control group. Patients were classified according to albumin/creatinine (A/C) ratio into three groups 15 patients for each group. Results:There was statistically significant difference between all studied groups as regards urinary podocin levels (P <0.001). urinary podocin levels appeared even in normoalbuminuria group with median 9.2 (7.1 – 12 ng/ml) which was significantly higher compared to control group with median 3.9 (2.2 – 4.8) ng/ml and the higher level was found in macroalbuminuria group with median 41.5 (38.5 – 48.5)ng/ml. Conclusion: Urinary podocin levels were highly sensitive early marker  to predict diabetic nephropathy in patients with type 2 diabetes mellitus for further  studies.