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Volume 12 Issue 4 ( October-December ) 2023

Original Articles

Study to determine urinary nephrin as an earlier marker in diabetic nephropathy than microalbuminuria.
Dr. Shyamala Rajendran, Dr. Sunithapriya Palaniappan, Dr. Santhi Natesan

Background: Microalbuminuria was previously considered as a gold standard in early detection of diabetic nephropathy despite being a non-specific marker. Decrease in Nephrin expression has been suggested to precede podocyte loss and linked to the progression of kidney disease.Present study was aimed to determine urinary nephrin as an earlier marker in diabetic nephropathy than microalbuminuria. Material and Methods:Present study was single-center, prospective, comparative study, conducted in patients with age > 18 years, Type 2 Diabetes, Diabetic Nephropathy, healthy individuals.Among the subjects, allocation was done into 3 groups based on history & investigations as Group DM MIC, Group DM NOR &Controls. Results:In present study, 90 subjects were equally allotted to Group DM MIC (n=30), Group DM NOR (n=30)&Controls (n=30). Significant positive correlation of strong strength of Urinary Nephrin levels was noted withDuration of DM (yrs), SBP (mm Hg)DBP (mm Hg), FBS (mg/dL), PPBS (mg/dL), blood urea (mg/dl), BUN, Sr. creatinine (mg/dL), eGFR (ml/min)&UMCR (Microalbumin creatinine ratio).The cut off of U.NEPHRIN(ng/ml) for predicting Nephropathy in Diabetic Normal albuminuria is 3.33 which had a sensitivity of 96.7%, specificity of 100%, positive predictive value of 100%, negative predictive value of 96.81% and a diagnostic accuracy of 98.35%.The cut off of U.NEPHRIN (ng/ml) for predicting Group is 6.09 which had a sensitivity of 96.7%, specificity of 98.3%, positive predictive value of 96.6%, negative predictive value of 98.35% and a diagnostic accuracy of 97.77%. Conclusion:Urinary nephrinhas greater diagnostic value in early detection of diabetic nephropathy compared to microalbuminas urinary nephrin levels were significantly increased in diabetic patients with nephropathy compared with diabetic patients without nephropathy and healthy non-diabetic individuals.

 
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