Relation of Growth Differentiation Factor 15 (GDF 15) to Early Diabetic Nephropathy

Abstract

Abstract Background Diabetic nephropathy (DN) is one of the leading causes of end-stage renal disease (ESRD) in developed countries and is becoming more prevalent globally due to the rise in the incidence of obesity and type 2 diabetes, DN is a progressive kidney disease caused by alterations in the glomerular capillary and tubular structure and function induced by the disturbed glucose homeostasis. Recent studies are conflicting regarding the sensitivity and the specificity of biomarkers currently used in practice for DN diagnosis (e.g., eGFR, albuminuria). Aim of the Work The aim of this work is to evaluate the relation of Growth Differentiation Factor 15 (GDF 15) to early Diabetic Nephropathy. For this purpose we study 90 adult diabetic patients classified into three groups: group (1); 35 patients with micro-albuminuria (UAE 30–299 mg/24 h), group (2); 35 patients with macro-albuminuria (UAE ≥ 300 mg/24 h), and group (3); 20 patients with norm-albuminuria (UAE <30 mg/24 h). It was found that there is no statistically significant difference between age and sex in the three studied groups, so patients in this study are matched in age and sex. Patients and Methods This cross-sectional comparative study involved 90 adult diabetic patients were selected from the patients attending the outpatient clinic of the Nephrology Department in Hurghada General Hospital. The study was performed at the period from January 2018 to January 2019. Results As regard the type of diabetes in our study there was statistically insignificant difference between microalbuminuric and macroalbuminuric groups in this study as regard type 1 and type 2 diabetes. Our data revealed that there is a statistically insignificant difference between the three studied groups as regard duration of diabetes, The study also showed that there was statistically insignificant difference between the two studied groups (1 & 2) as regard hypertension, while they were statistically significant compared to controls, This study showed that GDF-15 was markedly elevated in group 1 & 2 compared to control. There was statistically very highly significant difference between the two studied groups (1 & 2) and control group (3), while there is a statistically significant difference between group 1 and group 2. Conclusion In conclusion, the GDF-15 levels at the time of diagnosis have a significant negative correlation with the initial renal function and a significant positive correlation with a higher risk of disease progression in DN. Our result suggested that high GDF-15 reflects early renal injury and a mild degree of proteinuria in DN. GDF-15 is independent prediction to proteinuria level.