Анализ влияния маркеров почечного повреждения при нарушении углеводного обмена на риск появления неселективной протеинурии
М.А. Устинова, М.М. Батюшин
FSBEI HE "Rostov State Medical University" of RMH, Rostov-on-Don, Russia
Aim. To determine the prognostic significance of markers of kidney injury on the risk of non-selective proteinuria in patients with carbohydrate metabolism disorders.
Materials and Methods. 80 people were examined, including healthy people (n=11; control), patients with pre-diabetes (n=16, with impaired fasting glycemia or impaired carbohydrate tolerance), patients with type 2 diabetes mellitus (DM2) (n=53), among them patients without chronic kidney disease (CKD, no renal dysfunction and normal GFR [n=28]) and with CKD-normal GFR and presence of albuminuria (n=25). The mean age of the patients was 53.2±9.5 years. The duration of pre-diabetes in patients was 5.3 ± 1.3 months; patients without CKD suffered from DM2 for 12.3±7.8 months, with CKD – for 20.2±3.8 months. Anthropometric measurements, anamnestic data, and laboratory blood and urine parameters were assessed, including enzymes: α-glutathione S-transferase (αGST), π-glutathione S-transferase (πGST), matrix metalloproteinase-9 (MMP-9); GFR was calculated, and tests for the detection of albuminuria were performed.
Results. Combined evaluation with the inclusion of αGST allowed to increase the sensitivity and specificity of the methods for estimating the prognosis of the development of non-selective proteinuria. Evaluation of MMP-9 in combination with other factors also had high informative value in predicting the risk of developing non-selective proteinuria, but it should be noted that only the combination of αGST with MMP-9 and albuminuria allowed to increase the sensitivity of the technique with high specificity.
Conclusions. The data obtained during the study make it possible to compile prognostic risk tables for the development of nonselective proteinuria, depending on the factors that showed the most statistically significant results.
About the Autors
Ustinova M.A. – Postgraduate Student at the Department of Internal Diseases № 1, FSBEI HE "Rostov State Medical University" of RMH, Rostov-on-Don, Russia
Batyushin M.M. – Prof., Doctor of Medical Sciences, Professor at the Department of Internal Diseases № 2, Head of the Nephrological Unit of the Clinic of the FSBEI HE "Rostov State Medical University" of RMH, Rostov-on-Don, Russia