Abstract
Diabetic nephropathy (DN) is the main cause of chronic kidney disease in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Renal tubular lysosomal enzyme activities like N-acetyl-β-d-glucosaminidase (NAG) have been shown to increase in patients developing DN. The aim of this systematic review and meta-analysis is to evaluate the diagnostic accuracy of NAG, as a preventional biomarker in the early stages of DN in patients with diabetes mellitus. Two impartial reviewers conducted a complete PubMed search until July 2021. A 2 × 2 contingency table was created for each trial and sensitivity and specificity were estimated using a bivariate random effects model. To pool data and estimate the area under the curve (AUC), the hierarchical summary ROC (hsROC) approach was utilized. Deek’s test was used to estimate publication bias. The meta-analysis included 21 studies that evaluated 2783 patients with T1DM and T2DM, as well as 673 healthy individuals. The AUC of urinary NAG (uNAG) ranged from 0.69 (95% CI: 0.65–0.73) to 0.89 (95% CI: 0.86–0.92). According to the results, NAG in urine can be considered as a potential and effective biomarker for predicting DN in diabetic patients (T1DM, T2DM).
Highlights
Diabetic nephropathy (DN), is a metabolic disease and one of the most frequent microvascular complications of type 1 (T1DM) and type 2 (T2DM) diabetes mellitus [1]
Mated by area under the curve (AUC) for predicting DN in diabetic patients, for all groups ranged from to 0.89
Diabetic nephropathy is considered to be the main cause of end-stage renal disease and a critical complication in patients with T1DM and type 2 diabetes mellitus (T2DM)
Summary
Diabetic nephropathy (DN), is a metabolic disease and one of the most frequent microvascular complications of type 1 (T1DM) and type 2 (T2DM) diabetes mellitus [1]. DN is the leading cause of chronic kidney disease (CKD) and its diagnosis is based on the current level of albuminuria leading in three stages [3]: DN normoalbuminuria, microalbuminuria, and macroalbuminuria. The confirmation of the disease is based on the persistent albuminuria in early morning urine samples, due to glomerular hyperfiltration [4,5]. Albumin-to-creatinine ratio (ACR) is the gold standard method to detect elevated protein excretion in urine samples of diabetic patients. The onset stage of DN is defined by moderately increased albuminuria, known as microalbuminuria and it is diagnosed by the detection of a significant amount of albumin in the urine, which ranges from 30–300 mg/24 h [5]. It is increasingly appreciated that both glomerular and tubular interstitial damage have an essential role in the pathophysiology and development of DN [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
