Non-diabetic Nephropathy Group Research Articles

Establishment of a metabolite diagnostic model for the risk of diabetic nephropathy in type 2 diabetic population: Based on a cross-sectional study in China

IntroductionThis study aimed to investigate the correlation between various plasma metabolites and the likelihood of developing diabetic nephropathy (DN) and construct a diagnostic model for DN in Chinese patients with type 2 diabetes mellitus (T2DM). MethodsA cross-sectional investigation was conducted in a hospital setting. Based on medical data, a total of 743 patients from a tertiary hospital were selected and categorized into two groups: the diabetic nephropathy group (DN group) and the non-diabetic nephropathy group (non-DN group). Plasma levels of metabolites, including amino acids and acylcarnitines, were determined using a laser counter measurement system (LC-MS). Subsequently, partial least-squares regression was used to assess the significance of these metabolites. Receiver operating characteristic (ROC) curves were generated for factors that ranked highest in terms of relevance. Model performance was assessed using the curve (AUC). ResultsOf the 743 patients with T2DM admitted to the hospital, 145 had DN. Compared with the non-DN group, the DN group exhibited elevated systolic blood pressure (P ​= ​0.001), high-density lipoprotein cholesterol (P ​= ​0.01), and low-density lipoprotein cholesterol (P ​= ​0.042). Additionally, the DN group had a higher prevalence of stroke patients (P ​< ​0.001) and diabetic retinopathy patients (P ​< ​0.001). Finally, a risk model that included citrulline, leucine, tyrosine, valine, propionylcarnitine (C3), and palmitoylcarnitine (C16) was developed. This model achieved an AUC of 0.709, with a 95% confidence interval (CI) ranging from 0.626 to 0.793. ConclusionsA diagnostic model consisting of six plasma metabolites to assess the risk of DN in Chinese patients with T2DM may provide clues for future research.

Determinants of non-diabetic kidney diseases in type 2 diabetic patients: Twenty years of single center experience.

Diabetic nephropathy is one of the most common complications associated with diabetes. However, non-diabetic kidney disease has been reported in patients with type 2 diabetes at varying incidence rates. The objective of our study is to investigate the occurrence, clinicopathological characteristics, and inflammatory markers linked to diabetic and non-diabetic nephropathy (NDN) in patients with type 2 diabetes mellitus (DM). Additionally, we aimed to explore the possibility of identifying non-diabetic pathology using different biopsy indications. A total of 159 patients with type 2 DM who underwent renal biopsy at a tertiary care nephrology clinic between January 2000 and January 2022 were enrolled in the study. We collected comprehensive data, including patient demographics, co-morbidities, diabetes duration, renal biopsy indications and results, serological markers, renal function, diabetic retinopathy (DRP), full blood count, blood biochemistry, urinalysis, and inflammatory markers. Patients were categorized based on their biopsy indications, and their biopsy results were classified into three groups: isolated NDN, isolated diabetic nephropathy (DN), and mixed nephropathy with concurrent NDN. We evaluated the relationship between biopsy indications and accompanying pathologies and statistically assessed the likelihood of each biopsy indication detecting non-diabetic renal pathology. Additionally, differences in other data, including demographic and laboratory results and medical histories, among the three groups were investigated. The most frequent indication of renal biopsy was atypical presentations of nephrotic syndrome or nephrotic range proteinuria (ANS/ANP) in 25.1% of patients. Other indications included unexplained renal failure (URF) in 22.6%, atypical presentations of non-nephrotic range proteinuria (ANNP) in 18.2%, acute kidney injury or rapidly progressive kidney dysfunction (AKI/RPKD) in 16.9%, microscopic hematuria in 15.7%, URF with ANNP in 11.3%, and severe nephrotic range proteinuria (SNP) in 9.4%. Renal biopsy revealed isolated NDN in 64.8%, DN in 25.1%, and mixed nephropathy in 10.1% of patients. Primary glomerular diseases were the main non-diabetic renal pathology, predominantly focal segmental glomerulosclerosis (FSGS) (36.4%) followed by MN (10.6%) and IgA nephropathy (7.5%). In comparison with the isolated DN and mixed nephropathy groups, patients in the isolated NDN group had significantly shorter diabetes duration, fewer DRP, as well as lower serum creatinine and neutrophil-to-lymphocyte ratio (NLR). Multivariate logistic regression analysis revealed that presence of hematuria (OR 4.40; 95% CI 1.34 - 14.46, p = 0.014), acute nephrotic range proteinuria (OR 11.93; 95% CI 1.56 - 90.77, p = 0.017), and AKI/APKD (OR 41.08; 95% CI 3.40 - 495.39, p = 0.003) were strong predictors of NDN. Lower NLR (OR 0.77; 95% CI 0.60 - 0.98, p = 0.035), shorter duration of diabetes (OR 0.90; 95% CI 0.84 - 0.97, p = 0.010), and absence of DRP (OR 0.35; 95% CI 0.12 - 0.98, p = 0.046) were also found to be independent indicators of NDN. Receiver operating characteristic curve (ROC) analysis revealed a cut-off value of ≤ 3.01 for NLR (sensitivity of 63.1%, specificity of 63.5%) with regards to predicting non-diabetic renal pathology (p = 0.006). Renal biopsy findings in patients with type 2 DM highlight that the prevalence of NDN may be higher than assumed, as presented mainly in the form of primary glomerular disease. The presence of AKI/RPKD, hematuria, and ANS/ANP serves as a reliable indicator of non-diabetic renal pathology. In more ambiguous situations, factors such as a shorter duration of diabetes, absence of DRP, and a lower NLR value may assist clinicians in biopsy decision.

Risk Factors of the Progression of Renal Function Deterioration Among Patients with Diabetic Nephropathy

Objective: To explore the risk factors for the progression of renal function deterioration in patients with diabetic nephropathy (DN). Methods: The clinical data and biochemical indexes of 100 diabetic patients admitted to our hospital from October 2021 to October 2022 were retrospectively analyzed. The patients were divided into a DN group, which consisted of 55 cases, and a nondiabetic nephropathy group (NDN), which consisted of 45 cases. The urinary microalbumin to creatinine ratio, the clinical data (gender, age, duration of the disease, and BMI), and the biochemical indexes (triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], total cholesterol [TC], glycated hemoglobin A1c [HbA1c], systolic blood pressure [SBP], diastolic blood pressure [DBP]) of the two groups were compared. Subsequently, the risk factors related to the progression of renal function deterioration in DN were analyzed through multifactorial logistic regression analysis. Results: No statistically significant difference was observed in the comparison of gender, age, BMI, LDL-C, and DBP between the two groups (P &gt; 0.05). The DN group demonstrated a longer disease duration and higher SBP, TC, HDL-C, HbA1c, and TG compared to the NDN group (P &lt; 0.05). Through multifactorial logistic regression analysis, it was found that the duration of the disease, the TC, the HDL-C, the HbA1c, the TG, and the SBP were independent risk factors of the deterioration of renal function in DN patients. Conclusion: Other than conventional indicators, TC, HDL-C, HbA1c, TG, and SBP are also crucial indicators in determining the progression of renal function deterioration in DN patients.

Preliminary Study on the Evaluation of Multimodal Effects of Type 2 Diabetic Nephropathy

In order to explore the factors of patients with type 2 diabetic nephropathy (DN), in this paper, 257 patients with type 2 diabetic nephropathy in Zhejiang province were observed, with 156 males and 101 females. The age range was 53–69 years old. According to the ratio of urine albumin/creatinine, it was divided into two groups: the diabetic nephropathy group and the nondiabetic nephropathy group. Age, diabetic course, hypertension, body mass index, glycated hemoglobin, total gallbladder alcohol, high-density lipoprotein, and low-density lipoprotein were compared. The results showed that diabetic diseases, hypertension, HBA1C, and LDL-C were independent risk factors for diabetic nephropathy, and HDL-C was the independent protection factor of DKD ( P &lt; 0.05 ). Therefore, malnutrition and microinflammatory state are the risk causes of the quality of life and survival rate of type 2 diabetic nephropathy MHD patients and actively improve nutritional status. Reducing the status of microinflammatory disease is especially important.

Association between Protein Kinase C –B Isoform Level and Insulin Resistance in Pathogenesis of Iraqi Patients with Type 2 Diabetic Nephropathy Complications

Objective: The aim of the present study is to evaluate the association between serum PKC-B isoform activity levels and various biomarkers such as insulin resistance in sera of Iraqi patients with diabetic nephropathy complications. Methods: A cross-sectional study was performed on 100 samples obtained from Al-Hussein Teaching Hospital, Al-Hussein Medical City, Kerbala Health Directorates / Kerbala – Iraq during Nov., 2019 to Sep. 2020. Thirty patients have type 2 diabetic nephropathy, 40 patients with type 2 diabetic without nephropathy and 30 samples as apparently healthy control. Biochemical data, comprising serum PKC-B level, lipid profile, blood glucose, insulin, HOMA-IR and renal function tests such as urea, creatinine and GFR were investigated. Results: The study included 63% male and 37% female. The results indicated that there was a significant difference in blood glucose, HbA1c%, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), urea, creatinine, GFR and PKC-B between diabetic nephropathy and non-diabetic nephropathy groups (P-value &lt;0.05). Serum PKC-B activity was significantly correlated with blood glucose, HOMA-IR, creatinine and GFR among diabetic nephropathy group, while, HbA1c% and blood glucose was positively correlated with PKC-B level in non-diabetic nephropathy group. Conclusion: The observed data conclude that PKC-B level is higher in patients with diabetic nephropathy complication as compared with T2DM and healthy control. Also there is a significant correlation between PKC-B level and renal function tests in DN group which indicate an important role of PKC-B level in pathogenesis of diabetic nephropathy complications.

Related factors of diabetic nephropathy in patients with type 1 diabetes mellitus

Objective: To analyze the related factors of diabetic nephropathy in inpatients with type 1 diabetes mellitus (T1DM). Methods: A total of 300 patients with T1DM who were treated in the Department of Endocrinology of Anhui Provincial Hospital between 2014 and 2016 were analyzed retrospectively. All the patients were divided into two groups according to their urine albumin-to-creatinine ratio: non-diabetic nephropathy group (n=193) and diabetic nephropathy group (n=107). Multivariate logistic regression analysis was adopted to analyze the factors related to diabetic nephropathy in T1DM, including the age, diabetic duration, body mass index (BMI) and glycosylated hemoglobin (HbA1c) of the two groups. Results: Age, diabetes duration, HbA1c, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, triglyceride and uric acid (UA) of diabetic nephropathy group were higher than those of non-diabetic nephropathy group (all P<0.05). The total bilirubin, hemoglobin (Hb) and albumin in non-diabetic nephropathy group were higher than those in diabetic nephropathy group (P<0.05). The proportion of women in diabetic nephropathy group was higher than non-diabetic nephropathy group (62.6% vs 42.0%, P=0.001). Multivariate logistic regression analysis showed that diabetes duration (OR=2.142, 95% CI: 1.011-4.539), HbA1c (OR=1.262, 95% CI: 1.090-1.462), DBP (OR=1.048, 95% CI: 1.001-1.096), UA (OR=1.005, 95% CI: 1.001-1.009) and Hb (OR=0.952, 95% CI: 0.929-0.975) were independent related factors for diabetic nephropathy. Conclusions: Positive controlling of blood pressure, blood glucose, hyperuricemia and correcting anemia may reduce the incidence of diabetic nephropathy in T1DM patients.

Comparative analysis of diabetic nephropathy and non-diabetic nephropathy disease.

ObjectiveClinical symptoms of diabetic nephropathy patients and non-diabetic nephropathy are compared and analyzed, hemodialysis effect and quality of life of two kinds of nephrotic patients are analyzed.MethodsRespectively extract 1300 cases of diabetic nephropathy and non-diabetic nephropathy patients admitted to different hospitals during December 2011-December 2014. Based on whether the patient suffers from diabetes, they were divided into diabetic group and control group. Hemodialysis of two groups of patients were followed up to observe effectiveness of blood treatment, and complications were observed after one year of follow-up.ResultsHematodialysis effectiveness of diabetic nephropathy patients is significantly lower than that of non-diabetic nephropathy group. After 1 year’s follow-up, it can be found that survival rate of diabetic nephropathy patients is much lower than that of control group. In statistical comparison of data involved in the two groups of patients, P < 0.05, the difference is statistically significant.ConclusionTreatment effect of diabetic nephropathy patients is relatively poor compared to that of non-diabetic patients. In clinics, management and prevention of diabetic patients should be strengthened to avoid complication of nephropathy which brings serious injury to patients.

Comparison of Long-Term Outcomes between Peritoneal Dialysis Patients with Diabetes as a Primary Renal Disease or as a Comorbid Condition.

ObjectiveTo investigate the long-term outcomes of peritoneal dialysis (PD) patients with diabetes as primary renal disease and patients with diabetes as a comorbid condition.MethodsAll diabetic patients who commenced PD between January 1, 1995 and June 30, 2012 at Ren Ji Hospital, China were included. Patients were divided into diabetic nephropathy group (DN group) and non-diabetic nephropathy group (NDN group) according to their diagnosis of primary renal disease at the initiation of PD. They were followed until death, cessation of PD, transferred to other centers or to the end of study (June 30, 2013). Outcomes were analyzed by Kaplan-Meier method and Cox regression models.ResultsA total of 163 diabetic patients were enrolled in the study, including 121 (74.2%) in DN group and 42 (25.8%) in NDN group. The 1-, 2-, 3- and 5-year patient survival rates were 89%, 78%, 66% and 51% for DN group, and 85%, 63%, 53% and 25% for NDN group, respectively. Kaplan-Meier analysis showed that patients in NDN group had a worse patient survival compared with DN group (log rank 4.830, P=0.028). Patients in NDN group had a marginally shorter peritonitis-free period (log rank 3.297, P=0.069), however, there was no significant difference in technique survival (log rank 0.040, P=0.841). Multivariate Cox regression analysis showed that older age (HR 1.047, 95% CI 1.022-1.073, p<0.001), cardiovascular disease comorbidity (HR 2.200, 95% CI 0.1.269-3.814, P=0.005) and diabetes as a comorbidity condition (HR 1.806, 95% CI 1.003-3.158, P=0.038) were the independent predictors of increased mortality.ConclusionsPD patients with diabetes as a comorbidity had an inferior patient survival compared to those with diabetic nephropathy, and closer monitoring and extra attention in the former subgroup of patients are therefore warranted.

Age and anemia management: relationship of hemoglobin levels with mortality might differ between elderly and nonelderly hemodialysis patients.

BackgroundThe elderly hemodialyzed population is growing. However, little is known about the relationship between hemoglobin level and survival according to age. We investigated the effect of age on the relationship between hemoglobin and survival within the Japan Dialysis Outcomes and Practice Patterns Study (DOPPS) cohort.MethodsWe enrolled the entire Japan DOPPS phases 3 and 4 population. Patients were divided by the age of 75 years into two groups. Cox's proportional hazard model was used with hemoglobin at every 4 months treated as a time-dependent variable. The interaction of age and hemoglobin was analyzed.ResultsWe included 3341 patients in the analyses. The primary outcome occurred in 567 patients during the median follow-up of 2.64 years. Hemoglobin of entire population was 10.3 ± 1.3 g/dL. The median of epoetin dose was 3000 IU/week. Interaction was found between ages stratified by the age of 75 years and hemoglobin values (P = 0.045) with use of Cox's proportional hazard model. The nonelderly population had poorer prognosis with hemoglobin <10 g/dL, while elderly population only with hemoglobin <9 g/dL. For both hemoglobin strata <9, ≥9 and <10 g/dL, interactions between age and hemoglobin were significant. Subgroup analysis indicated that interaction between age and Hb levels was observed only in the nondiabetic nephropathy group. Several sensitivity analyses demonstrated a similar trend with the original analyses and reinforced the robustness.ConclusionsThe elderly population might tolerate low hemoglobin levels. Our findings open the way for further investigation of individualized anemia management.

Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism Contributes High Risk for Chronic Kidney Disease in Asian Male with Hypertension–A Meta-Regression Analysis of 98 Observational Studies

BackgroundAssociations between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms and chronic kidney disease (CKD) have been extensively studied, with most studies reporting that individuals with the D allele have a higher risk. Although some factors, such as ethnicity, may moderate the association between ACE I/D polymorphisms and CKD risk, gender-dependent effects on the CKD risk remain controversial.ObjectivesThis study investigated the gender-dependent effects of ACE I/D polymorphisms on CKD risk.Data sourcesPubMed, the Cochrane library, and EMBASE were searched for studies published before January 2013.Study eligibility criteria, participants, and interventionsCross-sectional surveys and case–control studies analyzing ACE I/D polymorphisms and CKD were included. They were required to match the following criteria: age >18 years, absence of rare diseases, and Asian or Caucasian ethnicity.Study appraisal and synthesis methodsThe effect of carrying the D allele on CKD risk was assessed by meta-analysis and meta-regression using random-effects models.ResultsEthnicity [odds ratio (OR): 1.24; 95% confidence interval (CI): 1.08–1.42] and hypertension (OR: 1.55; 95% CI: 1.04–2.32) had significant moderate effects on the association between ACE I/D polymorphisms and CKD risk, but they were not significant in the diabetic nephropathy subgroup. Males had higher OR for the association between ACE I/D polymorphisms and CKD risk than females in Asians but not Caucasians, regardless of adjustment for hypertension (p<0.05). In subgroup analyses, this result was significant in the nondiabetic nephropathy group. Compared with the I allele, the D allele had the highest risk (OR: 3.75; 95% CI: 1.84–7.65) for CKD in hypertensive Asian males.Conclusions and implications of key findingsThe ACE I/D polymorphisms may incur the highest risk for increasing CKD in hypertensive Asian males.

High incidence of Aggregatibacter actinomycetemcomitansinfection in patients with cerebral infarction and diabetic renal failure: a cross-sectional study

BackgroundRecent epidemiological studies suggest that periodontitis is a major risk factor for renal failure and cerebral infarction. The aim of this study was to evaluate the association among periodontitis, renal failure, and cerebral infarction, focusing on microbiological and immunological features.MethodsTwenty-one patients treated with hemodialysis (HD) were enrolled in this study. They were 8 with diabetic nephropathy and 13 with non-diabetic nephropathy. Blood examination, periodontal examination, brain magnetic resonance image (MRI), and dental radiography were performed on all patients. Subgingival plaque, saliva, and blood samples were analyzed for the periodontal pathogens, Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), and Prevotella intermedia (P. intermedia) using quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA).ResultsWe found that the patients with diabetic nephropathy had more A. actinomycetemcomitans compared with non-diabetic nephropathy (P = 0.038) in dental plaque. Furthermore, the patients with diabetic nephropathy showed a significantly higher incidence of cerebral infarction compared with those with non-diabetic nephropathy (P = 0.029). Clinical oral and radiographic scores tended to be higher among patients in the diabetic nephropathy group than in the non-diabetic nephropathy group.ConclusionsPeriodontal pathogens, particularly A. actinomycetemcomitans, may play a role, at least a part, in the development of cerebral infarction in Japanese HD patients with diabetic nephropathy.

Polymorphisms in Mn-SOD and EC-SOD gene and risk of nephropathy in Western Indian Type 2 diabetic patients

Single-nucleotide polymorphisms in genes related to oxidative stress are a risk factor for the development of diabetes and its complications. The allele and genotype frequencies of missense polymorphism Ala-9Val and Val16Ala in Mn-SOD and Arg213Gly in EC-SOD genes were studied in (a) patients with Type 2 diabetes mellitus (T2DM) without any complication (T2DM), (b) diabetic nephropathy (DN), (c) non-diabetic nephropathy (NDN) and (d) control healthy subjects from Western region of India. The PCR products were digested with BshTI, BsaWI and Eco52I restriction enzymes to detect Ala-9Val, Val16Ala and Arg213Gly polymorphisms respectively. The frequency of Val allele of Ala-9Val (P = 0.568 and P = 0.571) and Ala allele of Val16Ala (P = 0.993 and P = 0.152) polymorphisms of Mn-SOD gene did not show a significant difference in patient with T2DM and NDN compared to control subjects respectively. Frequency of Val allele of Ala-9Val (42.8 % vs. 61.5 %, P < 0.001) and Ala allele of Val16Ala (39.0 % vs. 53.5 %, P = 0.005) polymorphisms of Mn-SOD gene was significantly higher in patients with DN than that of patient with T2DM. For Arg213Gly polymorphism of EC-SOD gene, the Gly allele frequency in T2DM and NDN group did not significantly (P = 0.993 and P = 0.152 respectively) differ from control subjects as well as non-significantly higher in DN compared to T2DM. These results suggests that Ala-9Val and Val16Ala polymorphism in Mn-SOD is not involved in development of diabetes but may play a crucial role in determining genetic susceptibility to diabetic nephropathy in Western Indian Type 2 diabetic patients. Our data found a lack of association of EC-SOD (Arg213Gly) polymorphism with development of diabetes and diabetic nephropathy.

Diabetic nephropathy is associated with prostate-specific antigen levels in type 2 diabetes mellitus

Type 2 diabetes is associated with reduced risk of prostate cancer and low prostate-specific antigen levels for uncertain reasons. Recently, two studies demonstrated the time course of diabetes with prostate-specific antigen levels, which would be explained by the chronic renal complication. Therefore, we conducted a retrospective study to determine whether diabetic nephropathy is associated with prostate-specific antigen levels. Eligible patients were men aged ≥40 years, with type 2 diabetes and a recorded prostate-specific antigen level. Patients with a prior history of prostate cancer or prostatectomy or prostate-specific antigen level ≥10 ng/mL and patients with end-organ damage were excluded. Of the 247 patients included in the adjusted analysis, 51 (20.8 %) were diagnosed with diabetic nephropathy. A significant association of diabetic nephropathy with log-transformed prostate-specific antigen level was detected (Spearman's correlation coefficient -0.201, p = 0.003; adjusted for all other correlated variables) and fit into a linear regression model (B-coefficient -0.331, p = 0.003). Comparing diabetic nephropathy group with non-diabetic nephropathy group, the difference in log-transformed prostate-specific antigen levels was also significant (p = 0.002). The results indicated that patients with diabetic nephropathy have low prostate-specific antigen levels, suggesting fewer prostate cancers being detected or fewer incidences among this group.

TAFI and Diabetics.

Background: A novel risk factor for thrombotic disorders is thrombin activatable fibrinolysis inhibitor (TAFI) which is also known as plasma procarboxypeptidase B. TAFI is a potent inhibitor of tissue plasminogen activator - induced fibrinolysis, impairing the process of clot lysis and causing a tendency to thrombosis development. The increased circulating plasma levels of TAFI were reported in type 2 diabetes mellitus (DM), obesity, insulin resistance and in hypercholesterolemic subjects. TAFI plasma level was significantly higher in diabetic patients with microalbuminuria than those in diabetic patients with normoalbuminuria and normal subjects. These authors suggest that increased plasma level of TAFI may be involved not only in hypofibrinolysis but also in the mechanism of vascular endothelial damage in patients with type 2 DM.Aim of study: We evaluated the activity of activated TAFI (TAFIa) and its relation to another hemostatic and metabolic parameters in patients with diabetic nephropathy (DN).Patients and methods: Eighteen patients (pts) with diabetic nephropathy (DN) − 14 pts type 2 DM / 4 pts type 1 DM, age 54,1±13,3 years (12 men, 6 women), fourteen pts with non-diabetic nephropathy (NDN), age 49,7±15,6 years (7 men, 7 women) and twenty healthy subjects were enrolled in the study. TAFIa (Actichrome Activity TAFI kit, American Diagnostica), soluble thrombomodulin TM (sTM), von Willebrand factor (vWF), tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), homocysteine (Hcy), D-dimers plasma levels and metabolic parameters including glycosylated hemoglobin (HbA1c) were measured.Results: TAFIa plasma levels in DN pts were significantly decreased compared to NDN pts (7,22 ± 3,54 vs. 12,67 ± 6,99 ug/ml, p<0,01, respectively). After analysis the significant TAFIa decrease was only in those DN pts with hypercreatinemia and proteinuria. The sTM levels showed significant increase in DN pts with hypercreatinemia (p<0,0001). There was a significant positive correlation between TAFIa and HbA1c (r=0,50931, p<0,05).Conclusion: TAFIa plasma levels didn′t differ significantly in patients with diabetic nephropathy compared to those in control healthy group. Decreased TAFIa plasma levels in our DN pts with proteinuria and hypercreatinemia compared to NDN group may be due to the secondary (compensatory) increased fibrinolysis as a consequence of hypercoagulability in pts with DM. TAFIa was in a close relation to the metabolic compensation of DM (HbA1c) that can be of clinical importance for DN pts.

Erythrocyte sodium-lithium countertransport activity is related to membrane fluidity in IDDM patients.

Sodium-lithium countertransport (SLC) activity at a standard physiological sodium concentration is raised in uncomplicated IDDM, for which the kinetic mechanism is a raised maximum velocity (Vmax). Diabetic patients with nephropathy do not have raised values for Vmax but a low Michaelis constant (km). Transporter activity could be influenced by its membrane lipid environment. This was assessed in 21 control subjects, 32 uncomplicated diabetic patients, 17 patients with diabetic nephropathy and 11 patients with non-diabetic nephropathy by measuring the fluorescence anisotropy of DPH and TMA-DPH to assess different membrane regions. Standard SLC was higher in all the patient groups compared to the control subjects: 0.307 +/- 0.020 mmol Li/h x 1 cells in uncomplicated IDDM; 0.300 +/- 0.032 in diabetic nephropathy patients and 0.276 +/- 0.019 in non-diabetic nephropathy patients vs 0.216 +/- 0.011 mmol Li/h x 1 cells in control subjects (p < 0.001, p < 0.05, p < 0.05, respectively). This was due to raised Vmax values in the uncomplicated group: 0.528 +/- 0.035 vs 0.385 +/- 0.022 mmol Li/h x 1 cells in control subjects (p = 0.001) and low values for km in the diabetic nephropathy group: 58 (27-170) vs 106 (81-161) mmol/l in control subjects (p < 0.001). Raised SLC in the non-diabetic nephropathy group was largely due to raised Vmax: 0.460 +/- 0.030 mmol Li/h x 1 cells; p = 0.053, with no difference in km: 99.5 (74-137).(ABSTRACT TRUNCATED AT 250 WORDS)

Erythrocyte sodium-lithium countertransport activity is related to membrane fluidity in IDDM patients

Sodium-lithium countertransport (SLC) activity at a standard physiological sodium concentration is raised in uncomplicated IDDM, for which the kinetic mechanism is a raised maximum velocity (Vmax). Diabetic patients with nephropathy do not have raised values for Vmax but a low Michaelis constant (km). Transporter activity could be influenced by its membrane lipid environment. This was assessed in 21 control subjects, 32 uncomplicated diabetic patients, 17 patients with diabetic nephropathy and 11 patients with nondiabetic nephropathy by measuring the fluorescence anisotropy of DPH and TMA-DPH to assess different membrane regions. Standard SLC was higher in all the patient groups compared to the control subjects: 0.307±0.020 mmol Li/h x 1 cells in uncomplicated IDDM; 0.300±0.032 in diabetic nephropathy patients and 0.276±0.019 in non-diabetic nephropathy patients vs 0.216±0.011 mmol Li/h x 1 cells in control subjects (p<0.001, p<0.05, p<0.05, respectively). This was due to raised Vmax values in the uncomplicated group: 0.528±0.035 vs 0.385±0.022 mmol Li/h x 1 cells in control subjects (p=0.001) and low values for km in the diabetic nephropathy group: 58 (27–170) vs 106 (81–161) mmol/l in control subjects (p<0.001). Raised SLC in the non-diabetic nephropathy group was largely due to raised Vmax: 0.460±0.030 mmol Li/h x 1 cells; p=0.053, with no difference in km: 99.5 (74–137). DPH anisotropy was lower in the uncomplicated diabetic patients (0.210±0.0009) compared to the control subjects (0.214±0.0007: p=0.006) and was related to both standard SLC (rs=-0.68, p<0.001) and Vmax (rs= −0.77, p<0.001). Though DPH anisotropy in the diabetic nephropathy group was not different from normal control subjects, it also correlated with SLC (rs=-0.72, p<0.001) due to the same relationship with Vmax (rs=-0.73, p<0.001) as in uncomplicated diabetes. TMA-DPH anisotropy showed no difference between the four groups and was not related to either standard SLC, Vmax or km. Therefore, changes in membrane fluidity in the hydrophobic regions of the erythrocyte membrane may be responsible for some of the differences in SLC in IDDM.