Tag Archives: diabetic nephropathy

Thrombomodulin and von willebrand factor as markers of endothelial dysfunction in patients with chronic kidney disease

I. S. Mykhaloiko*, R. I. Yatsyshyn, N. V. Cherniuk, M. Ja. Humeniuk

Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine;
*e-mail: iralisn@gmail.com

Received: 23 December 2021; Accepted: 01 July 2022

The aim of research was to study the levels of thrombomodulin (TM) and von Willebrand factor (VWF) in the serum and urine of patients with chronic kidney disease (CKD)as diagnostic markers of endothelial dysfunction. The study involved 140 patients with CKD. The clinical diagnosis was determined based on standard methods of patients examination according to the kidney diseases classification and protocols of CKD patients management. The concentrations of TM and VWF in serum and urine were quantified by ELISA. A generalized endothelial dysfunction in the vessels of the whole body, including the kidneys and high concentration of TM and FVF in the serum and urine of patients with a diabetic nephropathy have been found. The concentration of TM and VWF in the serum of patients with a chronic glomerulonephritis was at the same level as in the serum of healthy individuals, while those in urine significantly exceeded the control values, indicating endothelial damage in the glomeruli of the kidneys due to exposure to pro-inflammatory cytokines. In our opinion, the studied markers will contribute to the timely diagnosis of endothelial dysfunction in patients with CKD and to the development of criteria for prescribing antiplatelet agents in glomerular kidney disease.

Urine neutrophil gelatinase-associated lipocalin as an early biochemical marker of microalbuminuria in predicting early kidney damage in patients with type 2 diabetes mellitus

P. J. Padmini, V. Ashok*

Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth Deemed to be University, Tamilnadu, India;
*e-mail: dr.ashokmbbs1986@gmail.com

Received: 08 July 2021; Accepted: 12 November 2021

Diabetic nephropathy is one of the microvascular complications of diabetes mellitus. The study was done to evaluate the diagnostic value of neutrophil gelatinase-associated lipocalin (NGAL) urine level as a biomarker for the early detection of nephropathy in type 2 diabetic patients. This study was performed on 150 patients with type 2 diabetes mellitus classified into three equal groups according to their urine albumin/creatinine ratio (ACR), including patients with normoalbuminuria (ACR < 30 mg/g creatinine), microalbuminuria (ACR = 30–300 mg/g creatinine) and macroalbuminuria (ACR > 300 mg/g creatinine). Fifty apparently healthy subjects were selected as a control group. Urine NGAL was estimated by a particle-enhanced turbidimetric immunoassay using Hitachi 917 analyzer. The serum  level of glucose and creatinine was also estimated. The results showed that NGAL urine level was significantly elevated in diabetes patient groups with microalbuminuria and macroalbuminuria when compared to the control group and diabetes patient group with normoalbuminuria. The levels of urine NGAL correlated positively with microalbuminuria in patients with diabetes. Receiver operating characteristic curves revealed that urine NGAL had a higher diagnostic value for diabetic nephropathy early detection compared to ACR and microalbuminuria in patients with diabetes mellitus.

D-dimer as a potential predictor of thromboembolic and cardiovascular complications in patients with chronic kidney disease

I. S. Mykhaloiko1*, I. O. Dudar2, I. Ja. Mykhaloiko1, O. Ja. Mykhaloiko1

1SHEE “Ivano-Frankivsk National Medical University”, Ivano-Frankivsk, Ukraine;
2SI “Institute of Nephrology AMS of Ukraine”, Kiev, Ukraine;
*e-mail: iralisn@gmail.com

Received: 13 February 2020; Accepted: 30 June 2020

The aim of the study was to evaluate the relationship between D-dimer levels and different biomarkers­ of renal diseases to identify the relationship between hypercoagulation and chronic kidney disease (CKD). To achieve this aim, we conducted a one-step prospective observational study involving 140 patients with CKD who were hospitali­zed in Ivano-Frankivsk Regional Clinical Hospital in Ukraine during 2018-2019. Of these patients, 100 patients (71.4%; 95% CI 53.4-76.7) had glomerulonephritis (GN) and 40 patients (28,6%; 95% CI 21.3-36.8) had diabetic nephropathy (DN). All patients underwent standard examination, which included general clinical, biochemical and instrumental research methods. D-dimer was quantitatively determined in blood serum by enzyme-linked immunosorbent assay (ELISA). The 140 patients were divided into two groups according to the level of D-dimers: normal level (<0.5 mg/l) and elevated level (≥0.5 mg/l). Elevated D-dimer levels were associated with an increased age of patients, decreased glomerular filtration rate, decreased blood albumin level, increased daily protein excretion and a tendency to develop thromboembolic complications during 1 year of monitoring. D-dimer is a biological marker that can detect hypercoagulation at an early preclinical stage in patients with CKD and identify patients with an increased cardiovascular risk, thereby promoting the earliest use of antiplatelet agents and anticoagulants  and, consequently, it can reduce mortality­.