Assessment of urinary nephrin level as an early predictor of diabetic nephropathy in type 2 diabetes mellitus patients

Document Type : Original Article

Authors

1 Clinical Pathology Department, Faculty of Medicine, Tanta University, Egypt

2 Internal Medicine Department, Faculty of Medicine, Tanta University, Egypt

10.21608/bbj.2025.361224.1090

Abstract

End-stage kidney disease is largely caused by diabetic nephropathy (DN), which affects 40% of people with type 2 diabetes mellitus (T2-DM). A podocyte protein called nephrin may be a useful biomarker for early detection of podocyte damage that occurs in the early stages of DN. This study aimed to assess urinary nephrin as early marker for diagnosis of DN in individuals with T2-DM. The study involved sixty T2-DM patients with duration less than five years from time of diagnosis and twenty healthy subjects. Based on their urinary albumin/creatinine ratio, the T2-DM participants were divided into three groups: Group (Gp1) patients with macroalbuminuria (n=20), Gp2: patients with microalbuminuria (n= 20) and Gp3: patients with normoalbuminuria (n=20). In addition, twenty apparently healthy subjects were enrolled as control group. Fasting blood glucose (FBG) and postprandial blood glucose (PPBG), glycated hemoglobin (HbA1c), homeostasis model assessment-estimated insulin resistance (HOMA-IR), kidney function and lipid profile were measured. Blood glucose levels showed high significant difference among patients and healthy individuals. FBG and PPBG were significantly increased in T2-DM patients with macroalbuminuria than T2-DM patients with microalbuminuria, normoalbuminuria and control groups. All groups of T2-DM patients had significantly higher urinary nephrin levels than healthy controls (p<0.001). There was significant positive correlation between urinary nephrin, FBG, PPBG, HbA1c, urea, creatinine, albumin-to-creatinine ratio (ACR), HOMA-IR, cholesterol, triglycerides (TG) and LDL. There was significant negative correlation between urinary nephrin, estimated glomerular filtration rate and HDL. Significantly elevated urinary nephrin levels may serve as a diagnostic and prognostic indicator for DN.

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