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Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
Published on: May 2, 2025
Normal-range albuminuria does not exclude nephropathy in diabetic children
Jacek Zachwieja1, Jolanta Soltysiak, Piotr Fichna
1Department of Pediatric Nephrology, Poznan University of Medical Sciences, Poznan, Poland. j.zachwieja@mp.pl
Pediatric Nephrology (Berlin, Germany)
|February 17, 2010
Summary
Neutrophil-gelatinase-associated lipocalin (NGAL) may detect early kidney damage in children with type 1 diabetes, even with normal albumin levels. This biomarker shows promise for identifying diabetic nephropathy earlier than traditional methods.
Area of Science:
- Pediatric Nephrology
- Diabetology
- Biomarker Discovery
Background:
- Diabetic nephropathy (DN) diagnosis often relies on microalbuminuria (MA), but early renal dysfunction can be missed.
- Renal biopsy, the gold standard for DN detection, is invasive.
- There is a need for sensitive, non-invasive markers to detect early renal changes in pediatric diabetes.
Purpose of the Study:
- To evaluate serum and urine neutrophil-gelatinase-associated lipocalin (NGAL) and interleukin (IL)-18 levels in children with type 1 diabetes (T1DM) and normal albuminuria.
- To assess the relationship between NGAL, IL-18, and albumin excretion rate (AER) in this cohort.
- To determine if NGAL can serve as an early indicator of diabetic nephropathy in children with normal albuminuria.
Main Methods:
- Studied 22 children with T1DM (age 12.7 ± 3.5 years, HbA1c 8.52 ± 1.78%) with normal estimated glomerular filtration rate (eGFR) and urinary albumin excretion.
- Measured serum and urine NGAL (sNGAL, uNGAL) and IL-18 levels.
- Compared NGAL and IL-18 levels with those of 14 healthy controls.
- Analyzed correlations between NGAL, IL-18, AER, eGFR, and HbA1c.
Main Results:
- Children with T1DM exhibited significantly higher sNGAL and uNGAL levels compared to healthy controls (p=0.04 for both).
- No significant differences in serum or urine IL-18 levels were observed between groups.
- A positive correlation was found between sNGAL and AER (r=0.51, p=0.014) and between uNGAL and AER (r=0.51, p=0.016).
- No significant relationships were found between NGAL levels and eGFR or HbA1c.
Conclusions:
- Elevated serum and urine NGAL concentrations in children with T1DM and normal albuminuria suggest subclinical renal involvement.
- NGAL may be a more sensitive biomarker than microalbuminuria for detecting early diabetic nephropathy in children.
- NGAL measurement holds potential as a valuable tool for monitoring renal health in pediatric diabetes patients.
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