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Background and Objectives: Diabetic nephropathy occurs as a result of proximal tubule dysfunction with
podocyte damage due to increased advanced glycation end-products’ insult in diabetes. Nephrin, one of
the three proteins that make up the podocyte architecture, is excreted foremost following renal damage.
The aim of this study was to evaluate the efficiency and reliability of nephrin for an early biomarker of kidney
damage in diabetic patients.
Methods: Urine samples (78) were collected from diabetic center. Protein and glucose were determined by
Dipstick. The patients were grouped on the basis of Albumin/creatinine ratio (UACR) as normoalbuminuric,
Microalbuminuric and Macroalbuminuric with UACR less than 30 mg/g, from 30-300mg/g, and above
300mg/g respectively. ELISA KIT (Exocell USA) was used for Nephrin estimation. Statistical evaluation was
done on SPSS version 20.
Results: Nephrinuria was present in 70(89.7%) out of 78 diabetic patients including 35(81.4%) of 43(55.1%)
normoalbuminurics, 5(6.4%) of 30(38.5%) microalbuminurics and all 5 of macroalbuminurics (p=0.027). Nephrinuria was found associated with duration of diabetes, 21(91.3%)/23 were positive with less than three years
of disease, 24(92.3%)/26 with three to seven years and 25(86.2%)/29 in more than seven years (p=0.039).
Nephrin levels were found increasing from normo- (0.86ug/ml) to Micro- (11.6µg/ml) to Macroalbuminuria
group (47.6µg/ml), compared to 0.15 µg/ml in comparison group.
Conclusion: The increase in Nephrin levels from 0.86µg/ml in patients with normal albuminuria to 47.6µg/ml in
patients with macroalbuminuria suggests that Nephrin precedes albumin in urine predicting early signs of
kidney damage. Nephrin biomarker can be used as predictor for early diagnosis of Nephropathy in
diabetics.
Moazzam A. Shahid, Saeeda Baig, Adnan M. Zubairi, Farha Ahmed. (2017) Expression Of Nephrin In Early Diagnosis Of Diabetic Nephropathy, The Pakistan Journal of Medicine and Dentistry, Volume-6, Issue-2.
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