title: Urinary neutrophil gelatinase-associated lipocalin and progression of diabetic nephropathy in type 1 diabetic patients in a four-year follow-up study.
abstract: BACKGROUND
  Neutrophil gelatinase-associated lipocalin (NGAL), a marker of renal tubular damage, predicts progression in non-diabetic chronic kidney. We evaluated urinary (u)-NGAL as a predictor of progression in diabetic nephropathy in type 1 diabetic (T1D) patients.
  
  
  METHODS
  As a substudy of a 4-year randomized, intervention study evaluating low-protein diet in T1D patients with diabetic nephropathy, 78 patients were studied with yearly measurements of u-NGAL (ELISA, BioPorto).
  
  
  RESULTS
  Decline in glomerular filtration rate (GFR) ((51)Cr-EDTA), and end-stage renal disease (ESRD) or death.
  
  
  RESULTS
  Mean age 40.7 (8.2) years and 50 men. 13 patients developed ESRD or died. Baseline GFR (mean, SD): 68 (31) ml/min/1.73 m(2). Baseline u-NGAL [geometric mean (95% CI)] and GFR were 15.6 ng/24 h (11.8-20.7) and 68 (31) ml/min/1.73 m(2). During follow-up, an increase in u-NGAL [geometric mean (95% CI)] of 15%/year (4-27) and a decline in GFR of 3.7 (3.0) ml/min/year were observed. Baseline u-NGAL was not associated with the decline in GFR. Elevated u-NGAL at baseline (log-transformed) predicted death and ESRD (HR 3.8, 95% CI 1.04-14.0), however not after adjustment for known progression promoters (HR 2.0, p = 0.6).
  
  
  CONCLUSIONS
  Elevated u-NGAL was not related to decline in GFR during a 4-year follow-up. Elevated u-NGAL was associated with the development of ESRD and death, but not after adjustment.
authors.affiliation: Steno Diabetes Center, Gentofte, Denmark. Sene@steno.dk
authors.forename: Stine Elkjaer
authors.initials: SE
authors.lastname: Nielsen
authors.forename: Henrik Post
authors.initials: HP
authors.lastname: Hansen
authors.forename: Berit Ruud
authors.initials: BR
authors.lastname: Jensen
authors.forename: Hans-Henrik
authors.initials: HH
authors.lastname: Parving
authors.forename: Peter
authors.initials: P
authors.lastname: Rossing
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D015415:Biomarkers / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology / Q000503:physiopathology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000473:pathology / Q000503:physiopathology / Q000652:urine*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000473:pathology / Q000652:urine*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000652:urine*
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins