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. 2020 Jun 24:13:2199-2207.
doi: 10.2147/DMSO.S258678. eCollection 2020.

Evaluation of Urinary Neutrophil Gelatinase Associated Lipocalin and Kidney Injury Molecule-1 as Diagnostic Markers for Early Nephropathy in Patients with Type 2 Diabetes Mellitus

Thuan Huynh Quang  1   2 , Minh Pham Nguyet  3 , Diep Pham Thao  4 , Minh Hoang Thi  1   2 , Lan Phuong Thi Dam  1   2 , Hang Ho Thi  1   2 , Anh Phan Van  1   2 , Thang Can Luong  5 , Mai Ngo Thi Tuyet  2 , Quy Dang Duy  1   2 , Binh Do Nhu  1   2 , Thuan Nghiem Duc  1   2
Affiliations

Evaluation of Urinary Neutrophil Gelatinase Associated Lipocalin and Kidney Injury Molecule-1 as Diagnostic Markers for Early Nephropathy in Patients with Type 2 Diabetes Mellitus

Thuan Huynh Quang et al. Diabetes Metab Syndr Obes. .

Abstract

Purpose: The purpose of this study was evaluating the early diagnostic value of two specific tubular markers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in diabetes nephropathy.

Patients and methods: Cross-sectional study was carried in three groups of patients from 10/2017 to 10/2018 in Military Hospital 103. Group I included 30 healthy peoples with estimated glomerular filtration rate (eGFR) >60 mL/min/1.73 m2 and urine albumin creatinine ratio (uACR) <30 mg/g. Group II included 30 type 2 diabetic patients having uACR <30 mg/g, eGFR >60 mL/min/1.73 m2. Group III included 30 type 2 diabetic patients having uACR >30 mg/g, eGFR >60 mL/min/1.73 m2.

Results: Urine KIM-1 and NGAL increased progressively from control group (57.29 ± 25.91 pg/mL; 25.71 ± 13.69 ng/mL) to the group of diabetic patients with uACR <30 mg/g (167.06 ± 44.01 pg/mL; 37.42 ± 10.89 ng/mL) and the group of diabetic patients with uACR ≥30 mg/g) (p < 0.05). There were moderate correlations between KIM-1 (r = 0.48, p < 0.05) and NGAL (r = 0.45, p < 0.05) with uACR. There was a mild correlation between KIM-1 and NGAL (r = 0.29, p < 0.05). KIM-1 and NGAL are the independent tests to detect diabetic nephropathy. The sensivity and specificity of KIM-1 with cut-off value of 174.95 pg/mL were 62.37% and 73.48%, respectively; the sensivity and specificity of NGAL with cut-off value of 35.2 ng/mL were 60.45% and 70.37%, respectively.

Conclusion: KIM-1 and NGAL in urine are independent markers for early diagnostic diabetic nephropathy.

Keywords: albumin urine; diabetic kidney disease; urine albumin creatinin ratio.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Concentration of urine KIM-1. Notes: The concentration of KIM-1 in urine increased from healthy control to diabetes groups. The group II was significantly higher than group I and group III had the highest concentration. P-values in Mann–Whitney test were showed in figure.
Figure 2
Figure 2
Concentration of urine NGAL. Notes: The concentration of urine NGAL increased from group I to III. The differences between groups were significant. Mann–Whitney test was used to compare two groups and calculate p value.
Figure 3
Figure 3
ROC curves analysis of NGAL, KIM-1, NGAL/Cr, KIM-1/Cr in diabetes patients with nephropathy group versus diabetes patients without nephropathy group. Notes: Receiver operating characteristic curves for urine markers for diagnosing nephropathy in T2D: (A) Urinary KIM-1 with AUC=0.576; (B) Urinary KIM-1/creatinine (uKIM-1/Cr) with AUC= 0.68; (C) Urinary NGAL with AUC = 0.692; (D) Urinary NGAL/creatinine (uNGAL/Cr) with AUC = 0.697. Abbreviations: uKIM-1, urinary KIM-1; uKIM-1/Cr, urinary KIM-1/Creatinin; uNGAL, urinary NGAL; uNGAL/Cr, urinary NGAL/Creatinin.
Figure 4
Figure 4
The correlation between NGAL and KIM-1. Notes: r, p-value with pearson correlation between urine NGAL and urine KIM-1 were showed on the figure.
See this image and copyright information in PMC

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