title: Is Urinary NGAL Determination Useful for Monitoring Kidney Function and Assessment of Cardiovascular Disease? A 12-Month Observation of Patients with Type 2 Diabetes.
abstract: Background. Diabetic kidney disease (DKD) may start as glomerular or tubular damage. We assessed kidney function during one-year-long observation of patients with type 2 diabetes mellitus (T2DM) after initiation of nephroprotective treatment, with emphasis on the changes in urinary neutrophil gelatinase-associated lipocalin (uNGAL), and evaluated the association between tubular damage and cardiovascular complications of T2DM.Materials and Methods. Adult T2DM patients (55) were assessed initially and 30 patients after 1 year. Albumin and uNGAL and creatinine were measured in first morning urine. Albumin/creatinine (uACR) and uNGAL/creatinine (uNCR) ratios were calculated.Results. In logistic regression, both uACR above 30 mg/g and uNCR the median (21.3μg/g) were associated with cardiovascular complications, independently of classical risk factors and diabetes duration. One year after initiation of treatment, a significant reduction in HbA1cwas observed. BMI and lipid profiles did not change. Increase in serum creatinine and reduction in eGFR occurred, along with decrease in uNGAL and uNCR. Increasing uNCR and uACR were associated with higher control HbA1c. The increase in uNCR was more frequent in patients with hypertension.Conclusions. Better glycemic control in T2DM patients results in improved tubular function, as reflected by reduced uNCR and uNGAL. First morning urine uNGAL and uNCR may be useful to assess renal function and cardiovascular risk, along with albuminuria and eGFR.
authors.affiliation: St. Queen Jadwiga Clinical District Hospital No. 2, Rzeszow, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Żyłka
authors.affiliation: St. Queen Jadwiga Clinical District Hospital No. 2, Rzeszow, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Gala-Błądzińska
authors.affiliation: Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Paulina
authors.identifier: 0000-0003-3667-857X
authors.initials: P
authors.lastname: Dumnicka
authors.affiliation: Department of Physiology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Piotr
authors.identifier: 0000-0003-3478-0108
authors.initials: P
authors.lastname: Ceranowicz
authors.affiliation: Department of Nephrology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Kuźniewski
authors.affiliation: Department of Pathophysiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Krzysztof
authors.identifier: 0000-0002-4732-7698
authors.initials: K
authors.lastname: Gil
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Rafał
authors.identifier: 0000-0001-6966-3732
authors.initials: R
authors.lastname: Olszanecki
authors.affiliation: Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Kuśnierz-Cabala
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000652:urine; D002318:Cardiovascular Diseases / Q000150:complications / Q000652:urine*; D003404:Creatinine / Q000097:blood / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000652:urine*; D003928:Diabetic Nephropathies / Q000652:urine*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007677:Kidney Function Tests / Q000379:methods; D008055:Lipids / Q000097:blood; D000071068:Lipocalin-2 / Q000652:urine*; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D007004:Hypoglycemic Agents; D008055:Lipids; D000071068:Lipocalin-2; D003404:Creatinine