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Utility of urinary netrin-1 levels in patients with type 2 diabetic nephropathy and its correlation with renal
Rahul Kumar Tomar1, Vadivelan Mehalingam2,3, Prashant Adole4
1Department of Medicine, Old Hospital Block, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), 3rd floor, Puducherry, 605006, India.
Purpose:
Netrin-1 is a urinary protein that may help in the diagnosis of diabetic nephropathy. The objectives of this study were to assess urinary netrin-1 levels in patients with type 2 diabetic nephropathy and to determine its correlation with renal function among them.
Methodology:
This cross-sectional analytical study was conducted at a tertiary care teaching hospital in south India for 18 months. Study subjects were divided into four groups: non-diabetics, diabetics with normal to mildly increased albuminuria, moderately increased albuminuria, and severely increased albuminuria. Urinary albumin was quantified by nephelometry for all study subjects. The ELISA technique estimated urinary netrin-1 levels in all groups.
Results:
Urinary netrin-1 levels were higher in diabetic subjects with normal to mildly increased and severely increased albuminuria than in the control group. Correlation analysis showed that there was a positive correlation of urinary netrin-1 with urinary albumin-creatinine ratio (UACR) and no correlation with estimated glomerular filtration rate (eGFR). Urinary netrin-1 showed a sensitivity of 88.3% and specificity of 75% at a cut-off value of 889.74 pg/mg creatinine for diagnosing diabetic nephropathy.
Conclusion:
Urinary netrin-1 levels were elevated in diabetic subjects with moderately and severely increased albuminuria as compared to non-diabetic subjects. It showed a positive correlation with the urinary albumin-creatinine ratio and no correlation with eGFR in diabetic subjects.
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