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BioMed Research International
Volume 2017 (2017), Article ID 4691389, 7 pages
https://doi.org/10.1155/2017/4691389
Research Article

Urinary Neutrophil Gelatinase-Associated Lipocalin Is Complementary to Albuminuria in Diagnosis of Early-Stage Diabetic Kidney Disease in Type 2 Diabetes

1Department of Dialysis and Nephrology, St. Queen Jadwiga Clinical District Hospital No. 2 in Rzeszów, Lwowska 60 Street, 35-301 Rzeszów, Poland
2Department of Medical Diagnostics, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
3Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, 15A Kopernika Street, 31-501 Krakow, Poland
4Department of Internal Medicine, Nephrology & Endocrinology, St. Queen Jadwiga Clinical District Hospital No. 2 in Rzeszów, Lwowska 60 Street, 35-301 Rzeszów, Poland
5St. Queen Jadwiga Clinical District Hospital No. 2 in Rzeszów, Lwowska 60 Street, 35-301 Rzeszów, Poland
6Department of Nephrology, Jagiellonian University Medical College, 15 Kopernika Street, 31-501 Krakow, Poland

Correspondence should be addressed to Agnieszka Gala-Błądzińska; lp.pw@ycsnizdalb

Received 4 January 2017; Revised 19 March 2017; Accepted 6 July 2017; Published 6 August 2017

Academic Editor: Richard Coward

Copyright © 2017 Agnieszka Gala-Błądzińska et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Two clinical phenotypes of diabetic kidney disease (DKD) have been reported, that is, with or without increased albuminuria. The aim of study was to assess the usefulness of urinary neutrophil gelatinase-associated lipocalin (uNGAL) for the early diagnosis of DKD in the type 2 diabetes mellitus (T2DM). Methods. The study group consisted of 123 patients with T2DM (mean age 62 ± 14 years), with urine albumin/creatinine ratio (uACR) < 300 mg/g and eGFR ≥ 60 ml/min/1.73 m2. The control group included 22 nondiabetic patients with comparable age, sex, and comorbidities. uNGAL, albumin, and creatinine were measured in the first morning urine samples. uACR and uNGAL/creatinine ratios (uNCR) were calculated. Results. In the control group, maximum uNCR was 39.64 µg/g. In T2DM group, 24 patients (20%) had higher results, with the maximum value of 378.6 µg/g. Among patients with uNCR > 39.64 µg/g, 13 (54%) did not have markedly increased albuminuria. Women with T2DM had higher uNCR than men (), without difference in uACR (). uNCR in T2DM patients correlated significantly with HbA1c. Sex, total cholesterol, and uACR were independent predictors of uNCR above 39.64 µg/g. Conclusions. Increased uNGAL and uNCR may indicate early tubular damage, associated with dyslipidemia and worse diabetes control, especially in females with T2DM.