Serum Soluble Tumor Necrosis Factor-α Receptor-1 and Renal Dysfunction in Type 2 Diabetes Mellitus Patients

Abstract

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs. Type 2 diabetes mellitus is the most prevalent form of diabetes and accounts for 90% of cases globally. Diabetic kidney disease is a common complication of diabetes mellitus and a significant cause of chronic kidney disease and end-stage renal failure globally. In clinical practice, estimated glomerular filtration rate (eGFR) and albuminuria are used to assess renal function. Tumor necrosis factor-α (TNF-α) is a functional 26-kDa homotrimer type II transmembrane protein. It is a central proinflammatory cytokine that is generated in a wide variety of cells, including hematopoietic cells (monocytes, macrophages, and T cells), fat and endothelial cells. The effects of TNF-α are mediated by two cell-surface receptors, tumor necrosis factor receptor1(TNFR1) and tumor necrosis factor receptor 2 (TNFR2). TNFR1 is present in normal glomeruli and is found to be upregulated on infiltrating leukocytes in response to renal injury. The aim of our present study was to determine serum concentration of soluble TNF receptor-1 (sTNFR1) in patients with type 2 DM and correlating it with various clinical and laboratory variables laying stress on kidney functions. We also tried to find if it can be used as an early predictor of renal dysfunction. This work was conducted on 90 type 2 diabetic patients; 45 patients with eGFR <60 ml/min/1.73m2 and 45 patients with eGFR ≥ 60 ml/min/1.73m2.