Urinary Biomarker N-acetyl-β-D-glucosaminidase Can Predict Severity of Renal Damage in Diabetic Nephropathy

Overview

Journal J Diabetes Metab Disord

Specialty Endocrinology

Date 2015 Feb 27

PMID 25717442

Citations 29

Authors

Gehan Sheira

Nashwa Noreldin

Almokadem Tamer

Mohamed Saad

Affiliations

Soon will be listed here.

Abstract

Background: Diabetic nephropathy is a clinical diagnosis where proteinuria is present in a patient with diabetes. Early intervention can significantly improve the prognosis. However, imprecision of the currently available biomarkers have impaired effective therapies in a timely manner. Urinary N-acetyl-β-D-glucosaminidase (NAG) is excreted in abnormally high amounts in many renal diseases. The aim of this study was to evaluate urinary NAG as an early biomarker in detection of diabetic nephropathy and whether it parallels the severity of kidney damage in different stages of diabetic nephropathy.

Methods: Fifty patients with type 2 DM were classified into 3 groups (normoalbuminurea, microalbuminurea and macroalbuminurea) and 10 healthy subjects served as a control group. Urinary NAG, albumin and creatinine were measured. Blood urea, serum creatinine, serum albumin, total proteins, serum cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting and postprandial blood glucose, HbA1c and creatinine clearance were measured for all subjects.

Results: All diabetic patients had a significantly higher level of urinary NAG compared to control. NAG value increased in parallel with the severity of renal involvement.

Conclusion: Urinary NAG expresses the degree of renal impairment in diabetic nephropathy.

Citing Articles

Hydrogen gas inhalation ameliorates glomerular enlargement after hypoxic-ischemic insult in asphyxiated piglet model.

Iwaki T, Nakamura S, Wakabayashi T, Nakao Y, Htun Y, Tsuchiya T Sci Rep. 2025; 15(1):1677.

PMID: 39799178 PMC: 11724992. DOI: 10.1038/s41598-025-85231-8.

Urinary N-acetyl-D-glucosaminidase can predict bleeding after a percutaneous kidney biopsy.

Goto H, Kobayashi Y, Sato H, Fukunaga T, Tanoue K, Yamashiro A BMC Nephrol. 2024; 25(1):234.

PMID: 39039446 PMC: 11265090. DOI: 10.1186/s12882-024-03658-z.

Diabetes and Renal Complications: An Overview on Pathophysiology, Biomarkers and Therapeutic Interventions.

Jha R, Lopez-Trevino S, Kankanamalage H, Jha J Biomedicines. 2024; 12(5).

PMID: 38791060 PMC: 11118045. DOI: 10.3390/biomedicines12051098.

Pathomechanisms of Diabetic Kidney Disease.

Sinha S, Nicholas S J Clin Med. 2023; 12(23).

PMID: 38068400 PMC: 10707303. DOI: 10.3390/jcm12237349.

Association between continuous glucose monitoring-derived glycemic control indices and urinary biomarkers of diabetic kidney disease: Hyogo Diabetes Hypoglycemia Cognition Complications study.

Takagi A, Kusunoki Y, Ohigashi M, Osugi K, Inoue C, Inoue M Acta Diabetol. 2023; 61(4):413-423.

PMID: 38006524 PMC: 10963564. DOI: 10.1007/s00592-023-02214-9.

References

Vaidya V, Niewczas M, Ficociello L, Johnson A, Collings F, Warram J . Regression of microalbuminuria in type 1 diabetes is associated with lower levels of urinary tubular injury biomarkers, kidney injury molecule-1, and N-acetyl-β-D-glucosaminidase. Kidney Int. 2010; 79(4):464-70. PMC: 3033751. DOI: 10.1038/ki.2010.404. View

. Standards of medical care in diabetes--2007. Diabetes Care. 2006; 30 Suppl 1:S4-S41. DOI: 10.2337/dc07-S004. View

Bagshaw S, Bellomo R . Early diagnosis of acute kidney injury. Curr Opin Crit Care. 2007; 13(6):638-44. DOI: 10.1097/MCC.0b013e3282f07570. View

Kuzniar J, Marchewka Z, Lembas-Bogaczyk J, Kuzniar T, Klinger M . Etiology of increased enzymuria in different morphological forms of glomerulonephritis. Nephron Physiol. 2004; 98(1):p8-14. DOI: 10.1159/000079932. View

Navarro J, Mora C, Muros M, Maca M, Garca J . Effects of pentoxifylline administration on urinary N-acetyl-beta-glucosaminidase excretion in type 2 diabetic patients: a short-term, prospective, randomized study. Am J Kidney Dis. 2003; 42(2):264-70. DOI: 10.1016/s0272-6386(03)00651-6. View

Mogensen C, Christensen C . Predicting diabetic nephropathy in insulin-dependent patients. N Engl J Med. 1984; 311(2):89-93. DOI: 10.1056/NEJM198407123110204. View

Sato R, Soeta S, Syuto B, Yamagishi N, Sato J, Naito Y . Urinary excretion of N-acetyl-beta-D-glucosaminidase and its isoenzymes in cats with urinary disease. J Vet Med Sci. 2002; 64(4):367-71. DOI: 10.1292/jvms.64.367. View

Kern E, Erhard P, Sun W, Genuth S, Weiss M . Early urinary markers of diabetic kidney disease: a nested case-control study from the Diabetes Control and Complications Trial (DCCT). Am J Kidney Dis. 2010; 55(5):824-34. PMC: 2864367. DOI: 10.1053/j.ajkd.2009.11.009. View

Keane W, Brenner B, de Zeeuw D, Grunfeld J, McGill J, Mitch W . The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy: the RENAAL study. Kidney Int. 2003; 63(4):1499-507. DOI: 10.1046/j.1523-1755.2003.00885.x. View

10.

Gall M, Hougaard P, Borch-Johnsen K, Parving H . Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study. BMJ. 1997; 314(7083):783-8. PMC: 2126209. DOI: 10.1136/bmj.314.7083.783. View

11.

Malyszko J, Bachorzewska-Gajewska H, Sitniewska E, Malyszko J, Poniatowski B, Dobrzycki S . Serum neutrophil gelatinase-associated lipocalin as a marker of renal function in non-diabetic patients with stage 2-4 chronic kidney disease. Ren Fail. 2008; 30(6):625-8. DOI: 10.1080/08860220802134607. View

12.

Han W, Wagener G, Zhu Y, Wang S, Lee H . Urinary biomarkers in the early detection of acute kidney injury after cardiac surgery. Clin J Am Soc Nephrol. 2009; 4(5):873-82. PMC: 2676184. DOI: 10.2215/CJN.04810908. View

13.

Kanakamani J, Ammini A, Gupta N, Dwivedi S . Prevalence of microalbuminuria among patients with type 2 diabetes mellitus--a hospital-based study from north India. Diabetes Technol Ther. 2010; 12(2):161-6. DOI: 10.1089/dia.2009.0133. View

14.

Kania K, Byrnes E, Beilby J, Webb S, Strong K . Urinary proteases degrade albumin: implications for measurement of albuminuria in stored samples. Ann Clin Biochem. 2010; 47(Pt 2):151-7. DOI: 10.1258/acb.2009.009247. View

15.

Pedersen M, Christiansen J, Pedersen E, Mogensen C . Determinants of intra-individual variation in kidney function in normoalbuminuric insulin-dependent diabetic patients: importance of atrial natriuretic peptide and glycaemic control. Clin Sci (Lond). 1992; 83(4):445-51. DOI: 10.1042/cs0830445. View

16.

. KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease. Am J Kidney Dis. 2007; 49(2 Suppl 2):S12-154. DOI: 10.1053/j.ajkd.2006.12.005. View

17.

Kaneko K, Chiba M, Hashizume M, Kunii O, Sasaki S, Shimoda T . Renal tubular dysfunction in children living in the Aral Sea Region. Arch Dis Child. 2003; 88(11):966-8. PMC: 1719339. DOI: 10.1136/adc.88.11.966. View

18.

Prashanth P, Sulaiman K, Kadaha G, Bazarjani N, Bakir S, El Jabri K . Prevalence and risk factors for albuminuria among type 2 diabetes mellitus patients: a Middle-East perspective. Diabetes Res Clin Pract. 2010; 88(3):e24-7. DOI: 10.1016/j.diabres.2010.02.004. View

19.

Nauta F, Bakker S, van Oeveren W, Navis G, Homan van der Heide J, Goor H . Albuminuria, proteinuria, and novel urine biomarkers as predictors of long-term allograft outcomes in kidney transplant recipients. Am J Kidney Dis. 2011; 57(5):733-43. DOI: 10.1053/j.ajkd.2010.12.022. View

20.

Alrawahi A, Rizvi S, Al-Riyami D, Al-Anqoodi Z . Prevalence and risk factors of diabetic nephropathy in omani type 2 diabetics in Al-dakhiliyah region. Oman Med J. 2012; 27(3):212-6. PMC: 3394354. DOI: 10.5001/omj.2012.48. View