Markers of Glomerular and Tubular Damage in the Early Stage of Kidney Disease in Type 2 Diabetic Patients

Table 3

Diagnostic accuracy data for selected serum and urine markers used to diagnose moderately increased albuminuria (uACR between 30 and 300 mg/g) among T2DM patients with eGFR > 60 ml/min/1.73 m². Values observed in healthy individuals are shown to enable comparison with selected cut-off values.

Marker	Reference values previously associated with healthy individuals	Detection of moderately increased albuminuria in T2DM
		AUC (95% CI)	Selected cut-off value	Sensitivity, %	Specificity, %
Serum cystatin C, mg/l	0.59–1.04^a	0.78 (0.65–0.91)	1.09	68	90
Serum NGAL, μg/l	Men 63.5 ± 33.4; Women 64.9 ± 46.5^b	0.69 (0.56–0.83)	61.0	79	61
Urine NGAL, μg/l	10.9 (6.0–38.2)^c	0.74 (0.60–0.87)	14.3	80	61
Urine NGAL/creatinine, μg/g	12.2 (5.9–27.9)^c	0.71 (0.53–0.89)	28.3	60	87
Urine KIM-1, μg/l	0.156–5.33^b	0.68 (0.54–0.81)	0.73	79	51
Urine KIM-1/creatinine, μg/g	0.225–3.20^b	0.84 (0.72–0.95)	1.81	67	92
Urine transferrin, mg/l	<2.17^a	0.73 (0.58–0.88)	2.41	47	98
Urine IgG, mg/l	<3.36^a	0.85 (0.72–0.97)	3.49	74	93
Serum uromodulin, μg/l	191.2 (89.1–299.1)^c	0.66 (0.53–0.80)	144	95	43

^aReference interval used in the laboratory that performed the measurement for the present study. ^bReference values reported by the manufacturer of the test used in the present study [43–45]. ^cPreviously reported values measured in the same laboratory and with the same tests as in the present study: urine NGAL, urine NGAL/creatinine [46], and serum uromodulin [38]. Low concentrations are associated with renal impairment. Abbreviations: see Table 1.