BACKGROUND: The involvement of nephrin in controlling renal function is unclear with the literature only emphasizing its role in albuminuria. We therefore investigated the potential association between nephrinuria as evidenced by the appearance of urinary immunopositive nephrin fragments, with multiple renal traits. METHODS: Western blot analysis of the urine samples from a cross-sectional study of 381 Chinese type 2 diabetic patients revealed four distinct protein fragments, indicative of nephrinuria. Albuminuria was measured in random spot urine samples using the albumin/creatinine ratio (ACR), while estimated glomerular filtration rate (eGFR) was calculated using the creatinine-based Modification of Diet in Renal Disease formula. RESULTS: Each nephrin fragment was associated with a decline in eGFR (smallest P = 0.001). Even with the inclusion of logarithmic form of ACR (ln ACR) in the multivariate model, nephrinuria still remained significantly associated with lower eGFR (smallest P < 0.05). Nephrinuria was also strongly associated with lnACR and this finding was independent of eGFR (smallest P < 0.001). Thus, nephrinuria was independently associated with both renal traits in the form of lnACR and eGFR. Furthermore, nephrinuria was significantly associated with lower eGFR even among normoalbuminuric patients (ACR ≤ 30 mg/g) (smallest P = 0.002), potentially implicating nephrinuria in the development of normoalbuminuric renal insufficiency. Apart from the renal traits under investigation, the presence of nephrinuria did not associate with other patient clinical characteristics. CONCLUSIONS: Nephrinuria was associated with multiple renal traits in type 2 diabetes even in normoalbuminuric patients who are traditionally perceived as having a low risk of chronic kidney disease.
BACKGROUND: The involvement of nephrin in controlling renal function is unclear with the literature only emphasizing its role in albuminuria. We therefore investigated the potential association between nephrinuria as evidenced by the appearance of urinary immunopositive nephrin fragments, with multiple renal traits. METHODS: Western blot analysis of the urine samples from a cross-sectional study of 381 Chinese type 2 diabeticpatients revealed four distinct protein fragments, indicative of nephrinuria. Albuminuria was measured in random spot urine samples using the albumin/creatinine ratio (ACR), while estimated glomerular filtration rate (eGFR) was calculated using the creatinine-based Modification of Diet in Renal Disease formula. RESULTS: Each nephrin fragment was associated with a decline in eGFR (smallest P = 0.001). Even with the inclusion of logarithmic form of ACR (ln ACR) in the multivariate model, nephrinuria still remained significantly associated with lower eGFR (smallest P < 0.05). Nephrinuria was also strongly associated with lnACR and this finding was independent of eGFR (smallest P < 0.001). Thus, nephrinuria was independently associated with both renal traits in the form of lnACR and eGFR. Furthermore, nephrinuria was significantly associated with lower eGFR even among normoalbuminuric patients (ACR ≤ 30 mg/g) (smallest P = 0.002), potentially implicating nephrinuria in the development of normoalbuminuric renal insufficiency. Apart from the renal traits under investigation, the presence of nephrinuria did not associate with other patient clinical characteristics. CONCLUSIONS: Nephrinuria was associated with multiple renal traits in type 2 diabetes even in normoalbuminuric patients who are traditionally perceived as having a low risk of chronic kidney disease.
Authors: Ony Araújo Galdino; Iago de Souza Gomes; Renato Ferreira de Almeida Júnior; Maria Imaculada Conceição Ferreira de Carvalho; Bento João Abreu; Marcela Abbott Galvão Ururahy; Barbara Cabral; Silvana Maria Zucolotto Langassner; Karla Simone Costa de Souza; Adriana Augusto de Rezende Journal: Sci Rep Date: 2022-10-20 Impact factor: 4.996
Authors: Belinda Jim; Mythili Ghanta; Andi Qipo; Ying Fan; Peter Y Chuang; Hillel W Cohen; Maria Abadi; David B Thomas; John Cijiang He Journal: PLoS One Date: 2012-05-17 Impact factor: 3.240
Authors: Stephen P O'Brien; Mandy Smith; Hong Ling; Lucy Phillips; William Weber; John Lydon; Colleen Maloney; Steven Ledbetter; Cynthia Arbeeny; Stefan Wawersik Journal: J Diabetes Res Date: 2013-04-24 Impact factor: 4.011