title: Urinary markers of renal inflammation in adolescents with Type 1 diabetes mellitus and normoalbuminuria.
abstract: OBJECTIVE
  Patients with the highest albumin:creatinine ratio within the normal range are at an increased risk for developing microalbuminuria. The mechanistic basis for this is unknown, but may be related to renal inflammation. Our goal was to characterize the urinary excretion of cytokines/chemokines in normoalbuminuric adolescents with Type 1 diabetes to determine whether higher range normoalbuminuria is associated with evidence of renal inflammation.
  
  
  METHODS
  Forty-two urinary cytokines/chemokines were measured in subjects who were screened for the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial. Urinary cytokines/chemokines were compared across low (n = 50), middle (n = 50) or high (n = 50) albumin:creatinine ratio tertile groups.
  
  
  RESULTS
  At baseline, participants in the upper tertile were younger and had shorter diabetes duration compared with the other groups. Other clinical characteristics were similar. Urinary levels of interleukin 6, interleukin 8, platelet-derived growth factor-AA and RANTES differed across albumin:creatinine ratio tertiles, with higher values in patients in the middle and high tertiles compared with the lower tertile (ANCOVA P ≤ 0.01).
  
  
  CONCLUSIONS
  Within the normal albumin:creatinine ratio range, higher urinary albumin excretion is associated with elevated urinary levels of inflammatory markers. Ultimately, this may provide mechanistic insights into disease pathophysiology and stratify the risk of nephropathy in Type 1 diabetes.
authors.affiliation: Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, ON, Canada. david.cherney@uhn.on.ca
authors.forename: D Z I
authors.initials: DZ
authors.lastname: Cherney
authors.forename: J W
authors.initials: JW
authors.lastname: Scholey
authors.forename: D
authors.initials: D
authors.lastname: Daneman
authors.forename: D B
authors.initials: DB
authors.lastname: Dunger
authors.forename: R N
authors.initials: RN
authors.lastname: Dalton
authors.forename: R
authors.initials: R
authors.lastname: Moineddin
authors.forename: F H
authors.initials: FH
authors.lastname: Mahmud
authors.forename: R
authors.initials: R
authors.lastname: Dekker
authors.forename: Y
authors.initials: Y
authors.lastname: Elia
authors.forename: E
authors.initials: E
authors.lastname: Sochett
authors.forename: H N
authors.initials: HN
authors.lastname: Reich
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000473:pathology / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D018925:Chemokines / Q000652:urine; D002648:Child; D003401:Creatine / Q000652:urine; D016207:Cytokines / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000473:pathology / Q000652:urine*; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation / Q000652:urine*; D008297:Male; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D018925:Chemokines; D016207:Cytokines; D003401:Creatine