Urinary neutrophil gelatinase-associated lipocalin in early detection of diabetic nephropathy; a pilot study

Abstract

Introduction: Diabetes results in the high prevalence of diabetes and the subsequent high incidence of nephropathy. However, there is no method with high sensitivity for the early detection of diabetic kidney disease. Objectives: The objective of this study was to evaluate the effect of the frequency of neutrophil gelatinase-associated lipocalin (NGAL) in the early diagnosis of diabetic nephropathy. Patients and Methods: Seventy-six diabetic patients who referred to the diabetes clinic of Tohid hospital were randomly selected and enrolled into this cross-sectional study. Patients with hypertension, primary and secondary glomerulopathy, every type of malignancy, infection, heart disease, pulmonary disease and other endocrine diseases, and significant renal failure (estimated glomerular filtration rate; eGFR≤30 mL/min) were excluded from the study. Demographic data were collected and the patients were divided into normal and abnormal groups based on the results of urine tests. Morning urine samples were then taken from the patients to measure creatinine, albumin, urine Alb/CR (albumin to creatinine) ratio and NGAL. Results: Of a total of 76 patients who were enrolled in the study, 39 persons (51.3%) were female. The mean age of the participants was 59.03 ± 11.74 years. In addition, 64 patients (84.2%) were in the normoalbuminuria group and 12 persons (15.8%) were in the microalbuminuria group. Urinary NGAL level was significantly higher in the microalbuminuria group than in the normal group since the difference was significant (P<0.001). We found urinary NGAL level had no significant relationship with eGFR value and the duration of diabetes (P>0.05). There was also a relationship between urinary NGAL and urinary Alb/CR ratio levels (P=0.001). Conclusion: The results of the present study showed a relationship between urinary NGAL and urine Alb/CR ratio levels which could be used as a suitable biomarker in the diagnosis of diabetic nephropathy. Moreover, urinary NGAL level had no significant relationship with eGFR and the duration of diabetes.