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  • Title: Nonalbumin proteinuria is a simple and practical predictor of the progression of early-stage type 2 diabetic nephropathy.
    Author: Kim JH, Kim SS, Kim IJ, Lee MJ, Jeon YK, Kim BH, Song SH, Kim YK.
    Journal: J Diabetes Complications; 2017 Feb; 31(2):395-399. PubMed ID: 27913013.
    Abstract:
    AIMS: Multiple biomarkers have emerged as a reliable predictor of the progression of diabetic nephropathy. The aim of this study was to pursue a more simple and practical predictor that can be applied in clinical practice. METHODS: The urine albumin-to-creatinine ratio (ACR), the nonalbumin protein-to-creatinine ratio (NAPCR), and the levels of six biomarkers were measured in 73 patients with type 2 diabetes and estimated glomerular filtration rates (eGFRs)≥60mL/min/1.73m2. The renal outcomes were the annual decline in eGFR and the development of chronic kidney disease (CKD) of stage 3 or greater. RESULTS: The average rate of eGFR decline over a median of 50months of follow-up was -2.48mL/min/1.73m2/year. After adjusting for nine clinical parameters, only the NAPCR showed a significant association with the annual eGFR decline (adjusted R2=0.139, P=0.042). The NAPCR predicted a higher probability of the development of CKD of stage 3 or greater and was more effective than any of the six urinary biomarkers in this respect (C-index 82.7, sensitivity 92.3, specificity 81.7). CONCLUSIONS: The NAPCR is a better and more practical predictor of the development and progression of CKD than are other urinary biomarkers in patients with early-stage type 2 diabetic nephropathy.
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