Abstract
Introduction: In the kidney, cells in the thick ascending limb of the loop of the Henle synthesized uromodulin (UMOD). This study aims to present the evaluation of the uromodulin serum concentration in diabetes mellitus type 2 (T2DM) patients in the early detection of kidney damage. Materials and methods: The study included 50 T2DM patients mean age of 60.75 ± 11.23 years estimated glomerular filtration rate (eGFR) 114.38 ± 22.12 ml/min and a control group of 20 healthy persons. We measured serum concentration of haemoglobin, urea, creatinine, uromodulin (ELISA method), and cystatin C (nephelometry). We determined formulas: Cockcroft-Gault# (combination Cockcroft-Gault for patients with BMI < 30 kg/m2 and Cockcroft-GaultLBW for patients with BMI ≥ 30 kg/m2), CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration equation), and simple Cystatin C. Results: T2DM patients had lower hemoglobin serum concentration as well as eGFR calculated by formulas: Cockcroft-Gault# and CKD-EPI. T2DM patients had significantly higher BMI and cystatin C compared to control group. T2DM patients had significantly lower serum uromodulin concentration (136.51 ± 84.34 vs 220.50 ± 92.39 ng/ml) than in controls. Significant positive correlation between uromodulin and Cockcroft-Gault# (r = 0.432, p = 0.000), CKD-EPI (r = 0.439; p = 0.000) formulas as well as simple cystatin C (r = 0.250, p = 0.02), but negative correlation with age (r = -0.476, p = 0.000), BMI (r = -0.313, p = 0.002) and cystatin C serum concentration (r = -0.293, p = 0.015) were found. Conclusion: The role of serum uromodulin concentration is not still fortified. The results of this study showed that reduced uromodulin serum concentration indicated early kidney damage in T2DM patients.
Highlights
In the kidney, cells in the thick ascending limb of the loop of the Henle synthesized uromodulin (UMOD)
The results of this study showed that reduced uromodulin serum concentration indicated early kidney damage in type 2 diabetes mellitus (T2DM) patients
T2DM patients had significantly lower estimated glomerular filtration rate (eGFR) calculated by formulas: Cockcroft- Gault# (p < 0.01) and chronic kidney disease (CKD)- EPI (p < 0.01) as well as simple cystatin C formula (p < 0.01), but significantly higher the cystatin C serum concentration (p < 0.01)
Summary
Cells in the thick ascending limb of the loop of the Henle synthesized uromodulin (UMOD). Cells in the early distal tubule and the thick ascending limb (TAL) of the loop of the Henle synthesized uromodulin (UMOD). UMOD is an 80- 90 kDa molecule, known as Tamm Horsfall protein [1]. The role that UMOD has in the kidney remains unclear, nephrologists have been researching this protein for the past 50 years. This proves the need for a better understanding of the role of this protein in health and disease states [3, 4]. The physiological role of uromodulin is not clearly defined, there is growing interest in determining this glycoprotein in serum and urine of patients with acute and chronic renal failure as a marker of renal function [1, 3, 5]
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