Follow Up of Value of the Intrarenal Resistivity Indices and Different Renal Biomarkers for Early Identification of Diabetic Nephropathy in Type 1 Diabetic Patients
DOI:
https://doi.org/10.3889/oamjms.2017.034Keywords:
Renal Doppler, NGAL, Kim-1, L-FABP, type 1 diabetesAbstract
AIM: To evaluate intrarenal resistivity index (RI) and different biomarkers of diabetic nephropathy (DN) with clinical signs of DN and its progression over time as early detection of DN.
PATIENTS AND METHODS: This longitudinal study included 48 type 1 diabetic patients who were studied at baseline and after three years. A blood sample was taken for assessment of glycosylated haemoglobin (HbA1), lipid profile and a urine sample was taken for assessment of albumin/creatinine ratio, Neutrophil gelatinase-associated lipocalin (NGAL), liver-type fatty acid binding protein (L-FABP) and kidney injury molecule-1 (Kim-1) at baseline and after three years. Forty diabetic patients did renal Doppler at baseline & after three years.
RESULTS: HbA1, waist/hip ratio, albumin/creatinine ratio, lipid profile, NGAL, KIM-1, L-FABP and resistivity index (RI) were significantly increased in follow-up. Twenty patients (41.7%) showed progression to albuminuria. RI showed a significant increase in follow-up study. ROC curve showed that RI and NGAL had the highest sensitivity (100%), followed by L-FABP (90%) and lastly KIM-1 (63.6%) in the prediction of DN.
CONCLUSION: High RI, NGAL, KIM-1 & L-FABP can be considered as early markers of diabetic nephropathy in type 1 diabetics and are associated with its progression over time, independent of albuminuria.Downloads
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