Urinary Nephrin Research Articles

Evaluation of urinary podocin and nephrin as markers of podocyturia in dogs with leishmaniosis

BackgroundRenal disease is the main cause of death in canine leishmaniosis. Detection of an active glomerular injury is important to identify early renal damage and to prevent the development of chronic kidney disease. Podocyturia can indicate renal injury, and podocyte-associated molecules such as podocin and nephrin can be used to identify podocyturia. The purpose of the study was to evaluate urinary podocin and nephrin concentrations in dogs with leishmaniosis as markers of podocyturia.MethodsA total of 35 healthy dogs and 37 dogs with leishmaniosis were enrolled in the study. Dogs with leishmaniosis were classified according to the staging of the International Renal Interest Society (IRIS). Urinary podocin and nephrin concentrations were measured in all dogs with a validated enzyme-linked immunosorbent assay test and normalized to creatinine (uPoC and uNeC, respectively). The demographic, clinical, and laboratory data from both groups were analyzed and compared. Subsequently, the laboratory results were analyzed and compared according to IRIS staging in dogs in IRIS stage I and dogs in IRIS stage II + III + IV. The Pearson’s correlation test evaluated the relationship between urinary markers of podocyturia.ResultsCompared with healthy dogs, lower urinary podocin [median values (IQR): 15.10 (11.75–17.87) ng/ml versus 8.63 (7.08–13.56) ng/ml; P < 0.01] and nephrin [median values (IQR): 3.2 (3.62–5.43) ng/ml versus 2.67 (2.06–3.44) ng/ml; P < 0.01] were found in infected sick dogs. No significant differences were observed in the uPoC and uNeC between the two groups. Urinary nephrin and podocin concentrations were higher in healthy dogs and in dogs in IRIS stage I (both P < 0.05) compared with dogs in IRIS stages II + III + IV. No significant differences were found for uPoC and uNeC between healthy dogs and dogs with leishmaniosis in different IRIS clinical stages.ConclusionsDogs with leishmaniosis had a low concentration of podocin and nephrin in more advanced IRIS clinical stages, when kidney disease was more severe compared with healthy dogs and dogs in IRIS stage I with mild disease. Urinary nephrin was detectable for the first time in healthy non-infected dogs.Graphical

Urinary Nephrin and Podocin Levels as Potential Predictors of Reduced Glomerular Filtration Rate after Kidney Transplantation

Urinary Nephrin and Podocin Levels as Potential Predictors of Reduced Glomerular Filtration Rate after Kidney Transplantation

Correlation of Asymmetric Dimethylarginine With Podocytopathy Markers in Diabetic Kidney Disease Patients.

Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease, and podocytopathy is an early manifestation of DKD characterized by the urinary excretion of podocyte-specific proteins, such as nephrin and podocin. Asymmetric dimethylarginine (ADMA)-a biomarker of endothelial dysfunction-is associated with progressive kidney dysfunction. However, the mechanism of endothelial dysfunction in DKD progression is unclear. The aim of this study was to investigate the correlations of ADMA levels with nephrin, podocin, and the podocin:nephrin ratio (PNR) in DKD patients. A cross-sectional study of 41 DKD outpatients was performed in two hospitals in Jakarta from April-June 2023. The collected data included the subjects' characteristics, histories of disease and medication, and relevant laboratory data. Serum ADMA was measured using liquid chromatography, while urinary podocin and nephrin were measured using the enzyme-linked immunosorbent assay (ELISA) method. A correlation analysis was performed to evaluate the correlation of ADMA with nephrin, podocin, and PNR. Regression analysis was performed to determine confounding factors. The mean value of ADMA was 70.2 (SD 17.2) ng/mL, the median for nephrin was 65 (20-283 ng/mL), and the median of podocin was 0.505 (0.433-0.622) ng/mL. ADMA correlated significantly with nephrin (r = 0.353, p = 0.024) and PNR (r = -0.360, p = 0.021), but no correlation was found between ADMA and podocin (r = 0.133, p = 0.409). The multivariate analysis showed that body mass index was a confounding factor. This study revealed weak positive correlations between ADMA and urinary nephrin and between ADMA and PNR. No correlation was found between ADMA and urinary podocin.

Association of biomarkers of endothelial function, coagulation activation and kidney injury with persistent albuminuria in sickle cell anaemia.

Persistent albuminuria (PA) is common in sickle cell anaemia (SCA). With the association of chronic kidney disease (CKD) with increased mortality, biomarkers that predict its development or progression are needed. We evaluated the association of select biomarkers with PA in adults with SCA using Kruskal-Wallis rank-sum test and logistic regression models, with adjustment for multiple testing. Of 280 subjects, 100 (35.7%) had PA. Median plasma levels of soluble vascular cell adhesion molecule-1 (VCAM-1) (1176.3 vs. 953.4 ng/mL, false discovery rate [FDR] q-value <0.003), thrombin-antithrombin complex (5.5 vs. 4.7 ng/mL, FDR q-value = 0.04), and urinary angiotensinogen (AGT) (12.2 vs. 5.3 ng/mg, FDR q-value <0.003), urinary nephrin (30.6 vs. 27.2 ng/mg, FDR q-value = 0.04), and urinary kidney injury molecule-1 (KIM-1) (0.8 vs. 0.5 ng/mg, FDR q-value <0.003), normalized to urine creatinine, were significantly higher in subjects with PA. In multivariable analysis, only urinary AGT (odds ratio = 1.058, FDR q-value <0.0001) remained a significant predictor of PA. In addition, soluble VCAM-1 (FDR q-value <0.0001), D-dimer (FDR q-value <0.0001), urinary AGT (FDR q-value <0.0001), KIM-1 (FDR q-value <0.0001), and nephrin (FDR q-value <0.0001) were significantly associated with urine albumin-creatinine ratio in multivariable analyses. Longitudinal studies to evaluate the predictive capacity of biomarkers for the development and progression of CKD in SCA are warranted.

Role of urinary nephrin to predict early onset of nephropathy in patients with type 2 diabetes mellitus

Nephropathy is most common complication in type 2 diabeticsubjects. Urinary nephrin is a podocyte specific protein, can be serve as a predict early nephropathy and its progression of diabetic nephropathy. A total 90 participants included were sub grouped as 60 cases and 30 healthy controls, a biochemical, clinical and experimental parameters were analyzed for all the study subjects. The data was interpreted by using statistics software SPSS and &amp;#60;0.05 was statistically significant. There were significantly increased levels of FBS, PPBS and glycated haemoglobin in type 2 diabetic cases when compared to controls. The urea, creatinine, uric acid and microalbumin were significantly elevated in type 2 diabetic with microalbuminuria when compared to type 2 diabetic with normoalbuminuria and controls. Additionally the urinary nephrin was significantly elevated in both groups of type 2 diabetics when compared to controls. This study suggests determination of urinary nephrin can be used as an early predictable and prognostic marker for nephropathy in patients with type 2 diabetics.

Urine Nephrin and Podocalyxin Reflecting Podocyte Damage and Severity of Kidney Disease in Various Glomerular Diseases-A Cross-Sectional Study.

Background/Objectives: Glomerulopathy is a term used to describe a broad spectrum of renal diseases, characterized by dysfunction of glomerular filtration barrier, especially of podocytes. Several podocyte-associated proteins have been found and proved their usefulness as urine markers of podocyte dysfunction. Two of them are nephrin (NEP) and prodocalyxin (PDC). This study aims to evaluate the association of podocyte damage, as it is demonstrated via the concentrations of urinary proteins, with clinical and histological data from patients with several types of glomerulonephritis. Methods: We measured urine levels of two podocyte-specific markers, NEP and PDC (corrected for urine creatinine levels), in patients with a wide range of glomerulopathies. Serum and urine parameters as well as histological parameters from renal biopsy were recorded. Results: In total, data from 37 patients with glomerulonephritis and 5 healthy controls were analyzed. PDC and NEP concentrations correlated between them and with serum creatinine levels (p = 0.001 and p = 0.013 respectively), and with histological lesions associated with chronicity index of renal cortex, such as severe interstitial fibrosis, severe tubular atrophy and hyalinosis (for PDC/NEP, all p < 0.05). In addition, the PDC and NEP demonstrated statistically significant correlations with interstitial inflammation (p = 0.018/p = 0.028). Regarding electron microscopy evaluation, PDC levels were correlated with distinct characteristics, such as fibrils and global podocyte foot process fusion, whereas the NEP/CR ratio was uniquely significantly associated with podocyte fusion only in non-immune-complex-mediated glomerulonephritis (p = 0.02). Among the other clinical and histological parameters included in our study, a strong correlation between proteinuria >3 g/24 h and diffuse fusion of podocyte foot processes (p = 0.016) was identified. Conclusions: Podocalyxin and nephrin concentrations in urine are markers of podocyte dysfunction, and in our study, they were associated both with serum creatinine and histological chronicity indices.

Urinary podocyte stress marker as a prognostic indicator for diabetic kidney disease

BackgroundDiabetic kidney diseases (DKD) is a the most common cause of end-stage kidney disease (ESKD) around the world. Previous studies suggest that urinary podocyte stress biomarker, e.g. podocin:nephrin mRNA ratio, is a surrogate marker of podocyte injury in non-diabetic kidney diseases.MethodWe studied 118 patients with biopsy-proved DKD and 13 non-diabetic controls. Their urinary mRNA levels of nephrin, podocin, and aquaporin-2 (AQP2) were quantified. Renal events, defined as death, dialysis, or 40% reduction in glomerular filtration rate, were determined at 12 months.ResultsUrinary podocin:nephrin mRNA ratio of DKD was significantly higher than the control group (p = 0.0019), while urinary nephrin:AQP2 or podocin:AQP2 ratios were not different between groups. In DKD, urinary podocin:nephrin mRNA ratio correlated with the severity of tubulointerstitial fibrosis (r = 0.254, p = 0.006). and was associated with the renal event-free survival in 12 months (unadjusted hazard ratio [HR], 1.523; 95% confidence interval [CI] 1.157–2.006; p = 0.003). After adjusting for clinical and pathological factors, urinary podocin:nephrin mRNA ratio have a trend to predict renal event-free survival (adjusted HR, 1.327; 95%CI 0.980–1.797; p = 0.067), but the result did not reach statistical significance.ConclusionUrinary podocin:nephrin mRNA ratio has a marginal prognostic value in biopsy-proven DKD. Further validation is required for DKD patients without kidney biopsy.

Urinary Nephrin: A Potential Biomarker of Early Glomerular Injury in a Cohort of Pregnant Women Attending Routine Antenatal Care Services.

Introduction: Glomerular injury may occur during pregnancy as a consequence of systemic disease and pregnancy-related medical complications. While urinary nephrin has been shown to provide early identification of preeclampsia (PE) in high-risk pregnancies, the role of urinary nephrin in determining glomerular injury in pregnant women is yet to be explored. This study aimed to investigate the use of urinary nephrin as a predictor for early glomerular injury in a study conducted at the Townville University Hospital. Methods and Materials: A cross-sectional study was conducted. All pregnant women with a full dataset (n = 273) were classified into three categories according to their urinary albumin-to-creatinine ratio (ACR): normoalbuminuria, microalbuminuria and macroalbuminuria. Continuous variables were compared between groups, and the cut-off value for the urinary nephrin-to-creatinine ratio (NCR) was determined to predict albuminuria as an indirect indicator of early glomerular injury. The percentages of pregnant women who had elevated nephrinuria were calculated for each of the ACR categories. Results: Urinary NCR positively correlated with urinary ACR (r = 0.29, p < 0.0001). Urinary NCR increased comparably in women with normoalbuminuria, microalbuminuria and macroalbuminuria. Using a cut-off value of 14 ng/mg, nephrinuria was detected in 65% of women with normoalbuminuria, 95% with microalbuminuria and 100% with macroalbuminuria. Of the normoalbuminuric women who had an elevated urinary NCR (> 14 ng/mg), 78% were diagnosed with a hypertensive disorder and 63% were diagnosed with diabetes in pregnancy. In women with PE, urinary NCR and ACR were significantly higher when compared to women who did not develop PE. The AUC of the ROC for urinary NCR was 0.74 (95% CI: 0.650-0.824), with a sensitivity of 97% and a specificity of 36% to predict glomerular injury and a sensitivity of 93% and specificity of 42% to predict glomerular injury of PE. Conclusion: The study found that urinary NCR were elevated not only in women with micro- and macroalbuminuria but also in pregnant women with normoalbuminuria. Increased urinary NCR without increased urinary albumin may be associated with early glomerular injury. Urinary NCR may be a more sensitive marker than microalbuminuria to detect early glomerular injury in women with systemic disease and adverse pregnancy outcomes.

The Correlation of MicroRNA-21 With the Nephrin, Podocin, and Urinary Albumin-Creatinine Ratio in Patients With Type 2 Diabetes and Albuminuria: A Cross-Sectional Study.

Diabetic kidney disease (DKD) is the most common and deranging microvascular complication of diabetes mellitus (DM). Podocytopathy is a key component of glomerular damage in DKD. Micro RNA-21 (miRNA-21) is an epigenetic regulator that plays a role in podocyte damage; however, the results of previous studies have not resolved the controversy about the role of miRNA-21 in the pathogenesis of DKD. The objective was to investigate the correlation between miRNA-21 levels and urinary nephrin, podocin, and urinary albumin-creatinine ratio (UACR) in patients with type 2 DM and albuminuria. This is a cross-sectional study. This study was carried out in internal medicine outpatient clinic of Cipto Mangunkusumo Hospital Jakarta, Indonesia. This study consisted of 42 adults with type 2 DM and albuminuria. The measurements include (1) Serum miRNA-21; (2) urinary podocin, nephrin, and albumin-creatinine ratio; and (3) serum miRNA-21 correlated to urinary podocin, nephrin, and albumin-creatinine ratio. The Spearman bivariate analysis to assess the correlation of miRNA-21 with nephrin, podocin, and UACR. The mean relative expression of miRNA-21 was 0.069 (0.024), the median for nephrin, podocin, and UACR was 35.5 (15.75-51.25) ng/mL, 0.516 (0.442-0.545) ng/mL, and 150 (94.56-335.75) ng/mL, respectively. A correlation between miRNA-21 and nephrin was observed (r = 0.598; P < .0001). There was a correlation between miRNA-21 and UACR (r = 0.604; P < .0001). No correlation was found between miRNA-21 and podocin. A lack of non-DM and non-albuminuric control population and small sample size. We could not exclude concurrent disease, and all other potential confounding variables, particularly those related to inflammation. The miRNA-21 can be considered an early biomarker for podocytopathy and albuminuria in DM, highlighting its potential for early diagnostic and therapeutic interventions. Further research is required to confirm these findings and explore their clinical applications, which could significantly alter management strategies for DKD.

The clinical significance of the determination of urinary biomarkers of podocytic damage and fibroangiogenesis in patients with diabetes mellitus

Chronic kidney disease (CKD) in patients with diabetes mellitus (DM) remains a global medical and social problem of the 21st century and the leading cause of end-stage renal disease (ESRD). Kidney damage in diabetes is multifactorial, and diagnosis is often delayed, since structural changes in the glomeruli of the kidneys are detected before the appearance of significant albuminuria (AU) and a decrease in glomerular filtration rate. In this regard, the search for new, early informative biomarkers for the diagnosis of CKD in patients with DM is extremely relevant.Target: To establish the significance of biomarkers of podocyte dysfunction and fibro and angiogenesis excreted in the urine for early diagnosis and assessment of the risk of progression of kidney damage in patients with DM. Materials and Methods: in 74 patients with type 1 and type 2 diabetes (30 and 44, respectively), podocyte proteins and markers of fibro and angiogenesis were determined in the urine by enzyme immunoassay.Results: in patients with diabetes, compared to healthy people, there is increased urinary excretion of podocyte damage markers - nephrin, podocin, and fibroaniogenesis markers – type IV collagen, TGFβ-1, VEGF. Concentrations of nephrin in urine &gt;7.18 ng/U/Cr urine and collagen &gt;12.88 ng/U/Cr urine reliably indicate kidney damage. In patients with diabetes in the absence of traditional signs of CKD, diagnostically significant concentrations of nephrin were detected in 22% of cases, and collagen in 16.6%.Conclusion: determination of nephrin and/or type IV collagen in urine can be used both for early diagnosis and for monitoring kidney damage in diabetes.

Urinary Nephrin Levels Among Pregnant Women With Preeclampsia in Lagos, Southwest Nigeria: An Analytical Cross-Sectional Study.

Hypertensive disorders in pregnancy are one of the leading causes of maternal and perinatal morbidity and mortality worldwide. The clinical utility of urinary nephrin as a diagnostic biomarker of preeclampsia is currently of research interest. However, this is yet to gain significant traction within clinical settings. We evaluated the association between maternal urinary nephrin levels and the occurrence and severity of preeclampsia among pregnant women in Lagos, Nigeria. We conducted an analytical cross-sectional study involving pregnant women diagnosed with preeclampsia as well as their age- and gestational-age-matched normotensive counterparts. We tested the association between high maternal urinary nephrin levels and the occurrence of preeclampsia without and with severe features. P < 0.05 was reported as statistically significant. The study showed that for every unit increase in urinary nephrin levels, the odds of preeclampsia increased by about ninefold (adjusted Odds ratio = 8.9, 95% confidence interval: 2.8-29.2, P < 0.001). The levels of urinary nephrin increased steadily with increasing severity of the disease: 1.9 ± 0.8 ng/mL in preeclampsia without severe features, 2.7 ± 0.7 ng/mL in preeclampsia with at least one severe feature, and 3.3 ±1.1 ng/mL in eclampsia. There was an association between elevated levels of urinary nephrin and preeclampsia and its severe variant. However, there is a need for more robust studies with a longitudinal characterization of urinary nephrin levels to establish causal relationships with preeclampsia, explore other potential risk factors of preeclampsia, and define the clinical usefulness of urinary nephrin as a potentially reliable and accurate predictive marker of preeclampsia among women in low- and middle-income countries (LMIC) settings.

Early growth response 1 as a podocyte injury marker in human glomerular diseases.

In human glomerular diseases, visualizing podocyte injury is desirable since podocytes do not regenerate and podocyte injury leads to podocyte loss. Herein, we investigated the utility of immunostaining for early growth response 1 (EGR1), which is expressed in injured podocytes from the early stages of injury in animal experiments, as a podocyte injury marker in human glomerular diseases. This study included 102 patients with biopsy-proven glomerular diseases between 2018 and 2021. The proportion of EGR1 expression in podocytes (%EGR1pod) was analyzed in relation to clinical and histopathological features, including glomerular and urinary podocyte-specific markers. %EGR1pod correlated significantly with the urinary protein:creatinine ratio, urinary nephrin and podocin mRNA levels, and glomerular podocin staining (rho=0.361, 0.514, 0.487 and -0.417, respectively; adjusted P=.002, <.001, <.001 and <.001, respectively). Additionally, %EGR1pod correlated with cellular/fibrocellular crescents (rho=0.479, adjusted P<.001). %EGR1pod was high in patients with glomerulonephritis, such as immunoglobulin A nephropathy (IgAN), lupus nephritis and antineutrophil cytoplasmic antibody-associated glomerulonephritis, and in those with podocytopathies, such as membranous nephropathy and primary focal segmental glomerulosclerosis, while %EGR1pod was low in patients with minimal change disease. In a subgroup analysis of IgAN, %EGR1pod was higher in Oxford C1 patients than in C0 patients. However, unexpectedly, patients with higher %EGR1pod were more prone to attain proteinuria remission, suggesting that EGR1 in the context of IgAN reflects reversible early injury. Our findings indicate that EGR1 is a promising potential marker for identifying active early podocyte injury in human glomerular diseases.

Correlation of Kidney Injury Molecule-1 and Nephrin Levels in Iraqi Patients with Diabetic Nephropathy

Background: Diabetic nephropathy is characterized by persistent microalbuminuria and metabolic changes that decline renal functions. Researchers have been prompted to explore new biomarkers such as KIM-1 and nephrin that may enhance the identification of disease. Objective: To Evaluate biomarker levels of kidney injury molculre-1 (KIM-1) concentration and nephrin as early and sensitive markers of nephropathy in type 2 diabetic patients. Method: One hundred T2DM patients were included in a cross-sectional study at the specialized center for endocrinology and diabetes, Baghdad. The first group includes 50 diabetic nephropathy (DN) patients, and the second group includes 50 T2DM patients without DN. Biochemical and clinical parameters were reported for participants, and serum and urine levels of KIM-1 and nephrin were analyzed by Enzyme-linked immunosorbent assay. Results: The study showed a significant increase in serum and urinary levels of KIM-1 and nephrin in DN patients compared to the control group. Serum nephrin is positively correlated with urinary nephrin, serum creatinine, ACR ratio, serum and urine KIM-1, and negatively correlated with the estimated glomerular filtration rate. Urinary nephrin was positively correlated with urinary albumin/creatinine ratio, KIM-1 level in both serum and urine, and negatively correlated with estimated glomerular filtration rate. Conclusion: KIM-1 and nephrin are specific and sensitive indicators of early-stage diabetic nephropathy-associated renal damage.

Serum suPAR and Urinary Nephrin as Novel Sensitive and Specific Markers for Diabetic Nephropathy in Patients with Type 2 DM

The most frequent reason of end-stage kidney disease (ESKD) is diabetic nephropathy (DN), highlighting the need of early detection, treatment, and prevention.

Urinary nephrin linked nephropathy in type-2 diabetes mellitus.

Diabetic nephropathy is a one of the risk factor for end stage renal disease in patients with type 2 diabetes mellitus. Urinary micr oalbumin currently marker using for diagnosis of nephropathy in type 2 diabetes mellitus due to its larger variability and less specificity. Urinary nephrin is podocyte protein can be act as a early predictable and prognostic marker than micro albumin for nephropathy in type 2 diabetes mellitus. This case-control prospective observational study included 60 type 2 diabetes mellitus and 30 controls after applying criteria. Basic biochemical, clinical and experimental data were measured and recorded. There was a significantly elevated level of urinary nephrin in type 2 diabetes mellitus patients when compared to controls. The urinary nephrin significantly elevated in normo albuminuria group only when compared to urinary ACR and it is positive association with kidney damage. This study concluded significantly elevated levels of urinary nephrin might be used for early diagnosis and prognostic marker for nephropathy in type 2 diabetes mellitus.

Urinary Nephrin is a Sensitive Marker to Predict Early Onset of Nephropathy in Type 2 Diabetes Mellitus.

Objective The present study has been designed to evaluate urinary nephrin that best predicts the occurrence of renal dysfunction in type 2 diabetes mellitus patients and its correlation with clinical parameters of nephropathy. Materials and Methods A total of 80 type 2 diabetes mellitus and 40 age- and gender-matched healthy controls were recruited. Biochemical and clinical parameters were analyzed in all the study participants. Analysis of variance was performed to compare the differences between the groups. Pearson's correlation analysis was used to analyze the association of nephrin with clinical parameters of nephropathy. Receiver operating characteristic curves were constructed to study the diagnostic accuracy of markers to identify diabetic nephropathy. Results The levels of nephrin were significantly elevated in both groups of type 2 diabetes mellitus patients when compared with healthy individuals ( p = 0.0001). The urinary nephrin was positively correlated with hemoglobin A1c and urinary albumin creatinine ratio ( r = 0.520, 0.657, p < 0.0001) and negatively correlated with estimated glomerular filtration rate ( r = -0.539, p < 0.0001). The diagnostic sensitivity and specificity of nephrin for nephropathy were 100 and 88%, respectively, and urinary albumin creatinine ratio was 43 and 76%, respectively. Conclusion The study findings suggest that nephrin levels are strongly and positively associated with nephropathy in type 2 diabetes mellitus patients and it has a greater potential to be an early predictable marker of nephropathy than urinary albumin creatinine ratio.

Urinary biomarkers of kidney injury in patients treated with anti-VEGF drugs

Antiangiogenic drugs are widely used in oncological practice and are aimed at inhibiting angiogenesis. Despite the high antitumor efficacy, their use may be limited by nephrotoxicity, and therefore the search for early biomarkers of kidney damage remains relevant, which will preserve a favorable safety profile of therapy. To determine urinary biomarkers of tubular and podocyte damage in patients receiving treatment with antiangiogenic drugs. The study included patients (n=50) who received intravenous anti-VEGF drugs (aflibercept, bevacizumab, ramucirumab) in various chemotherapy regimens. Concentrations of tubular damage markers KIM-1 (Kidney Injury Molecule-1) and NGAL (Neutrophil Gelatinase-Associated Lipocalin), hypoxia marker HIF-1 (Hypoxia-Inducible Factor 1-alpha) in urine samples were determined by enzyme-linked immunosorbent assay (ELISA) before treatment, and during 8 weeks of treatment. To assess the risk factors for kidney damage, a logistic regression analysis was performed with the inclusion of the main clinical and laboratory parameters. A decrease in the calculated GFR of CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration Formula) of less than 60 ml/min per 1.73 m2 at week 8 of treatment was noted in 42% of patients. An increase in NGAL, KIM-1, HIF-1 and nephrin in urine during the first two weeks of therapy predicted the development of renal damage by the 8th week of follow-up. When constructing ROC-curves, the high sensitivity and specificity of these urinary indicators as prognostic markers were established. Among the clinical and laboratory indicators, independent unfavorable prognostic factors of nephrotoxicity were an initial decrease in eGFR, a history of hypertension, an increase in the concentration of KIM-1 and HIF-1 in urine during the first two weeks of therapy. The predictors of renal damage in the treatment with antiangiogenic drugs were previously an increase in NGAL, KIM-1 and HIF-1 in urine during the first two weeks after the start of therapy.

Nephrin a biomarker of early glomerular injury in newly diagnosed untreated hypertensive subjects

Introduction and Aim: Hypertension and proteinuria is known to cause renal and cardiovascular disease and mortality in patients irrespective of diabetes. It is beneficial to identify proteinuria and probable glomerular injury early to take preventive measures from cardiovascular event. In our study, we aimed to evaluate whether a biomarker such as nephrin can detect early glomerular injury in treatment naïve hypertensive subjects. Materials and Methods: Forty newly diagnosed, treatment naïve hypertensive subjects were recruited for the study along with 40 normotensive controls after obtaining informed consent and procuring approval from. Institutional Ethics Committee. The hypertensive group was classified as diabetic and non-diabetic hypertensives and compared with apparently healthy controls (normotensive). Urine sample was analyzed for microalbumin, creatinine and nephrin. Blood sample was analyzed for glycated hemoglobin, urea, creatinine, sodium, and potassium. Statistical analysis was performed using ANOVA to compare the groups for various parameters. Odds ratio was calculated. Results: Hypertensives were sub-grouped based on amount of microalbumin excreted. Urine nephrin excretion was significantly higher in hypertensive subjects than normotensive subjects (nephrin cut-off: 0.09 mg/g of creatinine). Urine nephrin (mg/g) was found to be elevated (median 0.15; interquartile range, 0.12 and 0.17) in hypertensives with normoalbuminuria and it was significantly higher than normotensive subjects (median 0.07; interquartile range, 0.04 and 0.09). Conclusion: Urine nephrin may be used as a biomarker of early glomerular injury in hypertensive subjects even before microalbuminuria is detected.

Urinary tubular biomarkers as predictors of death in critically ill patients with COVID-19.

Aim: To evaluate the prediction capacity of urinary biomarkers for death in critically ill patients with COVID-19. Methods: This is a prospective study with critically ill patients due to COVID-19 infection. The urinary biomarkers NGAL, KIM-1, MCP-1 and nephrin were quantified on ICU admission. Results: There was 40% of death. Urinary nephrin and MCP-1 had no association with death. Tubular biomarkers (proteinuria, NGAL and KIM-1) were predictors of death and cutoff values of them for death were useful in stratify patients with worse prognosis. In a multivariate cox regression analysis, only NGAL remains associated with a two-mount survival chance. Conclusion: Kidney tubular biomarkers, mostly urinary NGAL, had useful capacity to predict death in critically ill COVID-19 patients.

Correlation of urinary nephrin with albubinuria to predict early onset of nephropathy in patients with type 2 diabetes mellitus

Nephropathy is a major microvascular complication in patients with type 2 diabetes mellitus (T2DM), where urinary albumin a gold standard and clinically using marker for detection of nephropathy. Some of the studies reported urinary albumin is not a marker for detection of nephropathy. Moreover, recent studies reported urinary nephrin was considered to be a predictable marker for nephropathy. The present study has been designed to evaluate the status of urinary albumin and nephrin to predict early onset of nephropathy in T2DM. The present study included 120 subjects, among these 80 subjects with T2DM again sub grouped into 2 based on ACR ratio (40 T2DM with Normoalbuminuria, 40 T2DM with Microalbuminuria) and 40 healthy controls. Routine biochemical parameters, urinary albumin were analysed by using standard laboratory methods and Urinary nephrin were analysed by using ELISA and statistical analysis was done by using Microsoft Excel Spread Sheets and SPSS Version 20.0. In T2DM Patients with Normoalbuminuria shows a significant elevation of urinary nephrin but no variation in urinary albumin levels. The urinary albumin levels were significantly elevated in Group 3 subjects when compared to Group 1 and Group 2 ( P .0001**).