Performance of Urinary Clusterin as a Biomarker for Diagnosis of Early Diabetic Nephropathy in type 2 Diabetes

Document Type : Original Article

Authors

1 lecturer of endocrinology and diabetes, Department of Internal Medicine, Faculty of Medicine, Port Said University, Port Said, Egypt.

2 Department of family medicine, faculty of Medicine, Zagazig University

3 Lecturer of clinical pathology, Faculty of Medicine, Zagazig University

4 lecturer of nephrology, Department of Internal Medicine, faculty of Medicine Zagazig University,

Abstract

Aims:
Diabetic kidney disease (DKD) is considered one of the rising issues nowadays due to the growing incidence of diabetes especially type 2. The use of variable novel biomarkers for early detection and correlation with DKD is a general direction in most of the current literature, so we aim to evaluate the diagnostic significance of urinary clusterin as an early marker of DKD and correlate its level with the traditional markers of DKD.
Methods:
An observational study included 90 subjects, 45 patients with type 2 diabetes (T2DM) and another 45 subjects without diabetes who were age, sex, and BMI matched. The group of diabetes was classified according to the level of albuminuria into 3 subgroups; normoalbuminuric, microalbumineric, and macroalbuminuric.
Results:
urinary clusterin was higher in the group with diabetes even in the absence of albuminuria compared to the control group with significantly higher levels of clusterin with the advancing of the albuminuric stage.
Conclusion:
Urinary clusterin is considered an early sensitive marker in predicting DKD in T2DM at a cutoff point of 16.9 ng/ml (Sensitivity 97.8%, specificity 97.8%), and its level showed a significant progression with the advancement of the stage of nephropathy.

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