Aim: To evaluate the association of tubular markers and diabetic retinopathy (DR) in 2-DM patients with normal creatinine(Cr) and urinary microalbumin/Cr(ACR).

Methods: In this study, we selected 1164 patients with 2-DM to integrate the clinical biochemical indexes and urinary alpha-1 microglobulin/Cr(A1CR), urinary immunoglobulin G/Cr(IGUCR), urinary transferrin/Cr(TRUCR), ACR and fundus examination. 274 patients underwent nuclear medicine 99mTc-EC to measure renal effective plasma flow (ERPF) and 99mTc-DTPA to measure glomerular filtration rate (GFR). They were divided into 2 groups: 52 cases with DR and 222 cases non-DR. Renal parameters were compared between 2 groups.

Results: In this cross-sectional study, we fund the tubular markers: A1CR, IGUCR, and TRUCR in the DR group were higher (P < 0.001) than non-DR group, while ERPF decreased (P < 0.001). The glomerular parameters: ACR was slightly higher in the DR group, GFR had no significant difference between 2 groups (P > 0.05). Pearson correlation analysis showed A1CR had a better correlation with GFR and ERPF (P < 0.001) than ACR (P > 0.05). In a binary logistic analysis, after adjusting sex, age, course of DM, and other factors, A1CR, IGUCR, and ERPF were still independently associated with DR.

Conclusion: In 2-DM patients, tubular indexes and DR were the sensitive and noninvasive biomarkers for early prediction of diabetic kidney disease.


L. Zhang: None. J. Lu: None.

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