Role of Nephrinuria in Early Diagnosis of Type 2 Diabetic Nephropathy at Zagazig University Hospitals

Abstract

Background: Diabetic nephropathy can be detected early with the help of the nephrin biomarker. Objective: The aim of the current work was to assess the level of nephrin in the urine of type 2 diabetic patients as a biomarker of early detection of diabetic nephropathy. Patients and Methods: This study included a total of sixty-six type 2 diabetic patients and 22 apparently healthy control subjects, attending at Departments of Clinical Pathology and Diabetic Clinic, Internal Medicine Department, Zagazig University Hospitals. The included participants were divided into four groups; Group A (control) consisted of 22 apparently healthy control subjects, Group B consisted of 22 type 2 diabetic patients with normo-albuminuria, Group C consisted of 22 type 2 diabetic patients with micro-albuminuria, and Group D consisted of 22 type 2 diabetic patients with macro-albuminuria. Urinary nephrin level was assessed among all participants. Results: The urine nephrin and the urine nephrin/creatinine ratio showed highly statistically significant differences between the study groups. Post hoc test showed that urine nephrin and urine nephrin/creatinine ratio were highly elevated in group B when compared to group A, also were elevated in group D when compared to group C and group D when compared to group B. Correlation matrix showed that there was significant positive correlation between duration of diabetes (years) with urine nephrin. Conclusion: It could be concluded that even in diabetic patients with normal albuminuria, urinary nephrin is elevated because it precedes albuminuria. Diabetic nephropathy can be diagnosed earlier with the help of this marker.