Podocyturia parallels proximal tubule dysfunction in type 2 diabetes mellitus patients independently of albuminuria and renal function decline: A cross-sectional study.
OBJECTIVE
Detection of podocytes in the urine of patients with type 2 diabetes may indicate severe injury to the podocytes. In the course of type 2 diabetes the proximal tubule is involved in urinary albumin processing. We studied the significance of podocyturia in relation with proximal tubule dysfunction in type 2 diabetes.


METHODS
A total of 86 patients with type 2 diabetes (34-normoalbuminuria; 30-microalbuminuria; 22-macroalbuminuria) and 28 healthy subjects were enrolled in the study and assessed concerning urinary podocytes, podocyte-associated molecules, and biomarkers of proximal tubule dysfunction. Urinary podocytes were examined in cell cultures by utilizing monoclonal antibodies against podocalyxin and synaptopodin.


RESULTS
Podocytes were detected in the urine of 10% of the healthy controls, 24% of the normoalbuminuric, 40% of the microalbuminuric, and 82% of the macroalbuminuric patients. In multivariate logistic regression analysis, urinary podocytes correlated with urinary albumin:creatinine ratio (p=0.006), urinary nephrin/creat (p=0.001), urinary vascular endothelial growth factor/creat (p=0.001), urinary kidney injury molecule-1/creat (p=0.003), cystatin C (p=0.001), urinary advanced glycation end-products (p=0.002), eGFR (p=0.001).


CONCLUSIONS
In patients with type 2 diabetes podocyturia parallels proximal tubule dysfunction independently of albuminuria and renal function decline. Advanced glycation end-products may impact the podocytes and the proximal tubule.
"Victor Babes" University of Medicine and Pharmacy, Department of Nephrology, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Ligia
L
Petrica
"Victor Babes" University of Medicine and Pharmacy, Department of Endocrinology, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania. Electronic address: mihaelamaria.vlad@yahoo.com.
Mihaela
M
Vlad
"Victor Babes" University of Medicine and Pharmacy, Department of Diabetes and Metabolic Diseases, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Adrian
A
Vlad
"Victor Babes" University of Medicine and Pharmacy, Department of Nephrology, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Gheorghe
G
Gluhovschi
"Victor Babes" University of Medicine and Pharmacy, Department of Nephrology, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Florica
F
Gadalean
"Victor Babes" University of Medicine and Pharmacy, Department of Pharmacology, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Victor
V
Dumitrascu
"Victor Babes" University of Medicine and Pharmacy, Department of Cellular and Molecular Biology, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Roxana
R
Popescu
"Victor Babes" University of Medicine and Pharmacy, Department of Nephrology, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Cristina
C
Gluhovschi
"Victor Babes" University of Medicine and Pharmacy, Department of Anatomy and Embryology, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Petru
P
Matusz
"Victor Babes" University of Medicine and Pharmacy, Department of Nephrology, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Silvia
S
Velciov
"Victor Babes" University of Medicine and Pharmacy, Department of Nephrology, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Flaviu
F
Bob
"Victor Babes" University of Medicine and Pharmacy, Department of Public Health Medicine, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Sorin
S
Ursoniu
"Victor Babes" University of Medicine and Pharmacy, Department of Pharmacology, P-ta Eftimie Murgu 2A, 300041 Timisoara, Romania.
Daliborca
D
Vlad
D000419:Albuminuria / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000652:urine; D016022:Case-Control Studies; D002478:Cells, Cultured; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology / Q000503:physiopathology* / Q000652:urine*; D003928:Diabetic Nephropathies / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D007677:Kidney Function Tests; D007687:Kidney Tubules, Proximal / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D050199:Podocytes / Q000473:pathology*; D016482:Urinalysis / Q000379:methods; D014556:Urine / Q000166:cytology*
Advanced glycation end-products; Albuminuria; Podocyturia; Proximal tubule; Renal function