MON-290 THE ASSOCIATION OF URINARY BIOMARKERS FORECASTS RENAL INJURIOUS EXTENT IN THE INCIPIENT TYPE 2 DIABETIC KIDNEY DISEASE PATIENTS

Abstract

Diabetic kidney disease (DKD) becomes a common health problem worldwide as one of the major microvascular complications of diabetes mellitus (DM). The incipient diagnosis and the noninvasive detections in clinic are thereby of major importance of preventing the progression from DKD to end-stage renal disease. Recently the increasing evidences have demonstrated the impaired absorption of the filtered proteins by renal tubular epithelium might also play the important roles in the incipient DKD patients. Despite this, the clinical significances of urinary biomarkers in predicting renal injurious extent of DKD are controversial. Therefore, this study aimed to evaluate ulteriorly the clinical significances of association of urinary biomarkers in predicting renal damaged extent of the type 2 DKD patients at the early stage in a signal-center. The study was performed on the 92 type 2 DM patients with the different levels of urinary albumin (UAlb) and certain range of serum creatinine (Scr). According to urinary albumin-to-creatinine ratio (UACR), all patients were categorized into 3 groups, a normo-albuminuria (< 30 mg/g creatinine) group, a micro-albuminuria (30-300 mg/g creatinine) group and a macro-albuminuria (> 300 mg/g ceatinine) group. In addition to UAlb and UACR, Scr, estimated glomerular filtration rate (eGFR) and urinary tubular biomarkers including urinary cystatin C (UCysC), urinary N-acety1-β-D-glucosaminidase (UNAG) and urinary retinal binding protein (URBP) were tested, respectively. In all patients, 24hUAlb and UACR showed the stepwise increases and the significant differences in normo-albuminuria, micro-albuminuria and macro-albuminuria groups. Additionally, UCysC, UNAG and URBP synchronously revealed the gradual increases along with albuminuria in the 3 groups, and there was a significant difference between normo-albuminuria and micro-albuminuria groups, as well as that between micro-albuminuria and macro-albuminuria groups. Moreover, 24hUAlb and UACR were positively correlated with UCysC, UNAG and URBP. In the 72 type 2 DKD patients with micro-albuminuria and macro-albuminuria, there was a positive correlation between UNAG and URBP, and that UCysC was positively correlated with UNAG and URBP. In the incipient type 2 DKD patients, increased UCysC, UNAG and URBP are independently associated with UAlb, and these urinary tubular biomarkers cooperated with UAlb may be widely used as the practical targets in clinic in predicting renal damaged extent.