title: Assessment of kidney function in diabetic patients. Is there a role for new biomarkers NGAL, cystatin C and KIM-1?
abstract: OBJECTIVE
  Assessment of kidney injury early detection in diabetic patients has great importance for therapy and prognosis. The aim of this study was to assess whether neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, and kidney injury molecule-1 (KIM-1) could represent sensitive markers of kidney function/injury in patients with coronary heart disease and diabetes.
  
  
  METHODS
  The study comprised 121 consecutive patients with diabetes referred for coronary angiography due to coronary heart disease and a reference group consisting of 64 patients without diabetes.
  
  
  RESULTS
  Cystatin C, serum and urinary NGAL values were significantly higher in diabetics than in non-diabetics. There was no significant difference in KIM-1 levels in both groups. Serum NGAL in diabetic group was associated with serum creatinine, fibrinogen, urinary NGAL, cystatin C and inversely related to kidney function assessed with 4 equations. After analysing levels of studied biomarkers in both groups, no significant difference in patients with estimated glomerular filtration rate (eGFR) below 60 ml/min/1.73m² was found. The analysis of patients with eGFR over 60 ml/min/1.73m² showed significant differences in cystatin C and urinary NGAL levels. The area under the curve for serum NGAL, urinary NGAL and cystatin C was 0.60 (95% CI, 0.51 to 0.69), 0.59 (95% CI, 0.5 to 0.68), 0.62 (95% CI, 0.54 to 0.71), respectively, good cut-off values of studied biomarkers to detect diabetes were not found.
  
  
  CONCLUSIONS
  NGAL, cystatin C and KIM-1 are not more useful than eGFR in the assessment of kidney function in diabetic patients with coronary heart disease.
authors.forename: U
authors.initials: U
authors.lastname: Matys
authors.forename: H
authors.initials: H
authors.lastname: Bachorzewska-Gajewska
authors.forename: J
authors.initials: J
authors.lastname: Malyszko
authors.forename: S
authors.initials: S
authors.lastname: Dobrzycki
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine*; D000368:Aged; D060050:Angina, Stable / Q000150:complications / Q000378:metabolism; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003327:Coronary Disease / Q000150:complications / Q000378:metabolism; D055316:Cystatin C / Q000097:blood*; D003928:Diabetic Nephropathies / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D005919:Glomerular Filtration Rate; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007677:Kidney Function Tests; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood* / Q000652:urine*; D008297:Male; D008562:Membrane Glycoproteins / Q000652:urine*; D008875:Middle Aged; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000097:blood* / Q000652:urine*; D012372:ROC Curve; D011991:Receptors, Virus
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D055316:Cystatin C; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus