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Background: Serum copeptin, the terminal part of the arginine vasopressin (AVP), is stable in plasma. The AVP is increased in diabetic patients and may play a role in the development of diabetic kidney disease. Objective: To evaluate the role of serum copeptin in the diagnosis of diabetic nephropathy in type-2 diabetes mellitus. Patients and Methods: 40 type-2 diabetes mellitus (T2DM) patients; divided into two groups, (20 with poor glycemic control, and 20 with good glycemic control), in addition to 20 non-diabetic healthy control subjects. The following investigations had been made; HbA1C, FBS, blood urea, serum creatinine and sodium, creatinine clearance (Ccr), glomerular filtration rate (eGFR), urinary protein, and urinary sodium. Serum copeptin levels were measured using an enzyme-linked immunoassay (ELISA). Results: Serum copeptin levels were significantly higher in (T2DM) patients with poor glycemic control than in (T2DM) patients with good glycemic control compared to the healthy control group. There was a significant positive correlation between serum copeptin and FBS, HbA1C, blood urea, serum creatinine, urinary Na, and 24-hour urinary protein, and a significant negative correlation with serum Na, eGFR, and creatinine clearance. The receiver operating characteristic (ROC) curve for the validity of serum copeptin, as a marker for diabetic nephropathy, at cutoff point 3452 pg/ml, showed 90% sensitivity, and 95% specificity. Conclusion: Serum copeptin is independently related to markers of kidney injury in T2DM and may be used as a marker for diabetic nephropathy.

Background: Peripheral arterial disease (PAD) is a common risk factor for mortality in hemodialysis (HD) patients. Pentraxin-3 (PTX3), an inflammatory mediator, is widely expressed in peripheral tissues and may have a predictive value for PAD. Objective: To evaluate the role of plasma PTX3 as a predictor for PAD in maintenance HD patients. Patients and Methods: 84 subjects were included; Group 1: 42 End-stage renal disease (ESRD) patients on maintenance HD, and Group 2: 42 Healthy controls. After history taking, examination, and routine laboratory investigations, the following was done; Assessment of lower limb arteries by Color and Pulsed Doppler Ultrasound, ankle-brachial index (ABI), measurement of high-sensitivity C-reactive protein (HS-CRP), and plasma Pentraxin-3 (PTX3) by ELISA. Results: The ABI in HD patients (0.67 ± 0.13) was significantly lower than controls (1.1±0.16), (P<0.001). HS-CRP levels in ng/ml in HD patients (10.5 ± 2.3) were significantly higher than controls (1.48 ± 0.34), (P<0.001). Plasma PTX3 levels in ng/ml in HD patients (6.87 ± 1.36) were significantly higher than controls (1.47 ± 0.25), (P<0.001). Plasma PTX3 had a significant negative correlation with ABI, and Hb% (P<0.001), and a significant positive correlation with cholesterol and triglycerides (P<0.001), whereas HS-CRP did not have correlation with ABI. Plasma PTX3 at a cutoff of 2.35 ng/ml showed a higher predictive value for PAD than HS-CRP at a cutoff of 2.25 ng/ml regarding sensitivity (95.2% vs 88.1%), and specificity (92.0% vs 86.7%) respectively, (P<0.001). Conclusion: Plasma PTX3 maybe used as a predictor for PAD in maintenance HD patients, with a high sensitivity and specificity.

Background: Hepatorenal syndrome (HRS) may result from decreased renal perfusion in advanced liver cirrhosis patients. Copeptin is co-secreted with the arginine vasopressin (AVP) and is increased in patients with decompensated liver cirrhosis, however, limited studies associated Copeptin with HRS.Objective: This study aimed to evaluate serum Copeptin as a predictor of HRS in advanced liver cirrhosis patients. Patients and Methods: A case-control study had been carried out on a total of 40 subjects divided into; Group 1: 20 decompensated cirrhotic patients with HRS, Group 2: 10 decompensated cirrhotic patients with normal kidney function, and Group 3: 10 healthy controls. The following had been made; history taking, clinical examination, laboratory investigations: complete blood picture, liver function tests, coagulation profile, serum sodium, and creatinine. Serum Copeptin was measured using an enzyme-linked immunosorbent assay (ELISA). Results: Serum Copeptin levels; mean ±SD in pmol/L were significantly increased in group 1 (HRS) (7.3±1.11) compared to group 2 (3.6±0.99) and group 3 (2.3±0.31) (P˂0.001). Serum Copeptin levels positively correlated with serum creatinine, prothrombin time, total bilirubin (P˂0.05), and negatively correlated with serum albumin (P˂0.05), and sodium (P˂0.001), with no correlation with other parameters. The receiver operating characteristic (ROC) curve for serum Copeptin validity as a predictor of HRS in advanced liver cirrhosis patients, at a cutoff of 3.99 pmol/L showed 95.1% sensitivity, 70.2% specificity, and 85.1% accuracy. Conclusion: Serum Copeptin may predict HRS in advanced liver cirrhosis with high sensitivity and specificity.

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