Study of Podocyturia as a marker of nephropathy in type 2 diabetes mellitus

Abstract

Podocyte injury plays a primary role in the pathogenesis and progression of diabetic nephropathy. It will be interesting to recognize podocyturia, as a first noninvasive marker of subclinical early renal damage, which may be a detectable before overt proteinuria and full blown glomerular disease development. The current study is aimed to assess the Urinary podocin level (podocyte-specific protein detected in urine using Antipodocin Antibody ELISA kit) as an early marker of the glomerular lesion in patients with type 2 diabetes mellitus. This study included 45 clinically stable type 2 diabetic patients with GFR (>60 ml/min/1.73m2) and excluded patients with fever, urinary tract infection, uncontrolled hypertension, congestive heart failure, malignancy or menstruation, collected from Ain Shams University Hospital. In addition to 10 healthy volunteers matched in age and sex as a control group were also included in our study. Patients were classified according to A/C ratio into three groups (normo, micro and macroalbuminuria groups) 15 patients for each group, with mean of age 49.8 ± 7.28 (years), mean of duration of DM 58.63 ± 26.79 (months), mean of GFR 89.59 ± 13.66 (ml/min/1.73m2) and mean of podocin level 23.84 ± 15.41 (ng/ml) ,and The most common comorbidity was Hypertension which was present in 44.4% of all cases. Results of our study demonstrated that there was statistically significant difference between all studied groups as regards podocin level (P <0.001). Podocin level appeared even in normoalbuminuria group (with mean of 10.77 ± 5.30 ng/ml) which was significantly higher compared to control (with mean of 3.50 ± 1.66 ng/ml) and the higher level was found in macroalbuminuria group (with mean of 42.50 ± 9.04 ng/ml).