Urinary MCP-1 and RBP: Independent predictors of renal outcome in macroalbuminuric diabetic nephropathy

Urinary MCP-1 and RBP: Independent predictors of renal outcome in macroalbuminuric diabetic nephropathy

Author Titan, S. M. Google Scholar
Vieira, J. M. Google Scholar
Dominguez, W. V. Google Scholar
Moreira, S. R. S. Autor UNIFESP Google Scholar
Pereira, A. B. Autor UNIFESP Google Scholar
Barros, R. T. Google Scholar
Zatz, R. Google Scholar
Institution Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Abstract Background: Albuminuria has been considered a sine qua non condition for the diagnosis of diabetic nephropathy (DN) and has been widely used as a surrogate outcome of chronic kidney disease (CKD). However, recent data suggest that albuminuria may fail as a biomarker in a subset of patients, and the search for novel markers is intense.Methods: We analyzed the role of urinary RBP and of serum and urinary cytokines (TGF-beta, MCP-1 and VEGF) as predictors of the risk of dialysis. doubling of serum creatinine or death (primary outcome. PO) in 56 type 2 diabetic patients with macroalbuminuric DN.Results: Mean follow-up time was 30.7 +/- 10 months. Urinary RBP and MCP-1 were significantly higher in patients presenting the PO, whereas no difference was shown for TGF-beta or VEGF. in the Cox regression, urinary RBP. MCP-1 and VEGF were positively associated and serum VEGF was inversely related to the risk of the PO. However, after adjustments for creatinine clearance, proteinuria, and blood pressure only urinary RBP (OR 11.6; 95% CI 2.7-49.2, p = 0.001 for log RBP) and urinary MCP-1 (OR 11.0; 95% CI 1.6-76.4, p = 0.02 for log MCP-1) remained as significant independent predictors of the PO.Conclusion: Urinary RBP and MCP-1 are independently related to the risk of CKD progression in patients with macroalbuminuric DN. Whether these biomarkers have a role in the setting of normoalbuminuria and microalbuminuria in DN should be further investigated. (C) 2012 Elsevier Inc. All rights reserved.
Keywords Diabetic nephropathy
Chronic kidney disease
MCP-1
VEGF
TGF-beta
RBP
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Date 2012-11-01
Published in Journal of Diabetes and Its Complications. New York: Elsevier B.V., v. 26, n. 6, p. 546-553, 2012.
ISSN 1056-8727 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 546-553
Origin http://dx.doi.org/10.1016/j.jdiacomp.2012.06.006
Access rights Closed access
Type Article
Web of Science ID WOS:000311267700015
URI http://repositorio.unifesp.br/handle/11600/35475

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