Abstract
Objective To indicate the mechanism of podocyte injury in diabetic nephropathy (DN) patients by identifying the urinary podocytes and observe the situation of detached podocytes in glomeruli ; to discuss the correlation between the urinary podocyte excretion and the proteinuria, blood glucose(FBG), serum creatinine (SCr)in DN patients by detection of theses items in different phases. Methods The DN patients were divided into five groups according to the CKD phases, and were divided into three groups according to the volume of proteinuria, namely small, medium and large-volume-proteinuria group. Urinary podocytes and the podocalyxin (PCX) expression state of podocytes in glomeruli were identified and observed by indirect immunofluorescent method. The urinary podocytes of every group were caculated respectively. Then the podocyte number were calculated respectively. Meanwhile, the 24 h proteinuria, FBG and the SCr of DN pateints were tested. The correlation among the proteinuria, SCr, FBG and the urinary podocyte number of DN pateints was analyzed statistcally. Results Urinary podocytes were found in 88 percent of patients with DN, whereas 0 of patients with MCD and healthy cases. The absence of expression of PCX was found in DN patients.In contrast, PCX was expressed integrally in MCD patients.The podocytes in small-volume-proteinuria group was (1.5±1.0)/ml, medium-volume-proteinuria group (2.2±0.7)/ml and large-volume-proteinuria group (3.5±1.3)/ml, respectively.The difference from small and medium groups were not signifficent statistically, the others were all significant. The podocyte number increased according to the proteinuria. The correlation between urinary podocyte number and proteinuria, SCr of CKD Ⅰ to Ⅲ DN patients and urinary podocytes number were positive statistically. However, the correlation between SCr of CKD Ⅳ to Ⅴ patients and urinary podocyte number , FBG and urinary podocyte number were not significant statistically. Conclusions the mechanism of the podocyte injury in DN patients is present.The podocyte injury in DN may positively correlate to the proteinuria and SCr of CKD Ⅰ to Ⅲ patients, but the FBG and SCr of CKDⅣ-Ⅴpatients may not correlate to the urinary podocyte number. Key words: Diabetic nephropathies; Podocytes; Proteinuria; Blood glucose
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