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Utility of urinary podocalyxin levels in patients with and without type 2 diabetic nephropathy and its correlation
Jothivanan Perumal1, Vadivelan Mehalingam2, Ramesh Ramasamy3
1Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 3rd floor, Institute Block, Puducherry, 605006, India.
Purpose:
Podocalyxin is a urinary protein that may serve as a potential indicator for the early detection of diabetic nephropathy. The objectives of this study were to assess urinary podocalyxin levels in patients with and without type 2 diabetic nephropathy and to determine its correlation with renal function.
Materials And Methods:
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 without albuminuria, diabetics with microalbuminuria, and diabetics with macroalbuminuria. Urinary albumin was detected by the dipstick method in a spot urine sample for all study subjects. Urinary albumin was quantified by nephelometry. The enzyme-linked immunosorbent assay (ELISA) technique estimated urinary podocalyxin levels in all groups.
Results:
Urinary podocalyxin levels were elevated in diabetic subjects compared to the control group. There was a positive correlation between urinary podocalyxin and urine albumin-creatinine ratio (UACR) in diabetic study subjects. No correlation was found between urinary podocalyxin and estimated glomerular filtration rate (eGFR). Urinary podocalyxin showed a sensitivity of 85% and specificity of 64% (at a cut-off value of 275.56 ng/mL) in estimating albuminuria in diabetic subjects. Urinary podocalyxin showed a sensitivity of 89% and specificity of 78% (at a cut-off value of 273.38 ng/mL) in estimating eGFR in diabetic subjects.
Conclusion:
Urinary podocalyxin levels were elevated in patients with type 2 diabetic nephropathy. It was positively correlated with the urine albumin-creatinine ratio in diabetic subjects. However, there was no correlation with the estimated glomerular filtration rate.
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