title: Influence of protein kinase C (PKC) on the prognosis of diabetic nephropathy patients.
abstract: OBJECTIVE
  To investigate the association between protein kinase C (PKC) and the prognosis of patients with diabetic nephropathy (DN).
  
  
  METHODS
  92 patients with DN who had received treatments with angiotensin converting enzyme inhibitor (ACEI) or angiotensin-receptor blockade (ARB) were collected. The clinicopathologic characteristics were recorded and a 4-year follow-up with the final result of impaired renal functions (eGFR < 40 mL/min) was conducted. The expression of PKC was detected by immunohistochemical assay. Kaplan-Meier and Cox regression analysis were performed to estimate the effects of PKC on DN prognosis.
  
  
  RESULTS
  According to immunohistochemical analysis, there were 54 cases with positive expression of PKC (positive rate 58.7%). Meanwhile, during the follow-up, the urine protein, mean serum creatinine and eGFR in patients with positive PKC were all higher than those in negative expression group (P < 0.05). The expression of PKC was influenced by age (P < 0.001), course of disease (P < 0.001), blood pressure (P = 0.002), blood glucose (P < 0.001), HbA1c (P = 0.002), renal functions of patients before (P = 0.011) and after (P = 0.041) the biopsy. Besides, the Kaplan-Meier curve revealed that patients with positive PKC expression had shorter survival time than those with negative PKC expression (P < 0.001). Cox regression analysis indicated that HbA1c (P = 0.009), renal functions of patients after the biopsy (P = 0.002) and PKC (P = 0.028) were important factors in the prognosis of DN and they might be independent prognostic markers.
  
  
  CONCLUSIONS
  The expression of PKC is relatively higher in DN patients than in healthy controls. And PKC may be a valuable prognostic marker for patients with DN.
authors.affiliation: Second Department of Endocrinology, Tai An Central Hospital Shandong Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.affiliation: Second Department of Endocrinology, Tai An Central Hospital Shandong Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D003928:Diabetic Nephropathies / Q000201:enzymology* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011493:Protein Kinase C / Q000032:analysis / Q000096:biosynthesis*
chemical_list: D015415:Biomarkers; D011493:Protein Kinase C
keywords: PKC; diabetic nephropathy; prognosis
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