Much more than proteinuria in diabetic kidney disease

Document Type : Original Article


1 Faculty of medicine Alexandria University internal medicine department

2 Department of internal medicine faculty of medicine Alexandria University


Background: One of the most common long term complications of type 2 diabetes is Diabetic nephropathy (DN). Classically, DN progresses from the normo-albuminuric stage to microalbuminuria to end in overt proteinuria. Recently it has been shown that there might be rapid decline of glomerular filtration rate (GFR) in diabetic normo-albuminuric patients. Aim: This work aimed to compare data referring to both proteinuric and non-proteinuric type 2 diabetic patients and to study the significance of urinary liver-type fatty acid–binding protein in both groups. Material and methods: 200 patients were studied and divided into 2 groups, Group I: 100 diabetic patients with eGFR < 75 mL/min, without albuminuria and Group II: 100 diabetic patients with eGFR < 75 mL/min with albuminuria. History taking, clinical examination and laboratory tests including GFR, serum creatinine, HbA1c and L-FAB were assessed. Results: No clinically significant difference was found between the 2 groups regarding BMI, duration of diabetes, BP, S.creatinine, eGFR and retinopathy. Urinary L-FAB levels were significantly greater in non- albuminuric compared to the other group. Conclusion and Recommendations: non-albuminuric DKD is increasing and clinicians should pay much attention to it, larger studies are to assess this phenotype’s regarding pathogensesis and potential biomarkers. Urinary LFABP may be a useful biomarker for non-albuminuric DKD.


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