Role of urinary podocalyxin in early diagnosis of diabetic nephropathy

Abstract

Introduction: Podocyte injury has been reported as an early feature of DN therefore, the assessment of podocyte injury can be accomplished by estimation of podocalyxin in urine. This study aimed to estimate the urinary podocalyxin levels and to determine the sensitivity and specificity of this biomarker for early detection of DN.Materials and methods: A total of 90 patients with type 2 diabetes mellitus (T2DM) were included in this cross-sectional study. Sixty of them were without diagnosed DN, and 30 with diagnosed DN. A control group consisted of 30 healthy subjects. All patients with T2DM were divided into three subgroups according to urinary microalbumin/creatinine ratio (UM/CR): normoalbuminuric, microalbuminuric and macroalbuminuric patients. Urine samples, were used for measurement of podocalyxin by ELISA, creatinine and microalbumin. Fasting venous blood samples was collected for biochemical analyses.Results: The levels of urinary podocalyxin (u-PDX) were higher in patients with T2DM compared to control subjects and a statistically significant difference among studied subgroups regarding u-PDX was found (p < 0.05). Levels of u-PDX are increasing gradually with the degree of DN (p < 0.029). u-PDX levels were positively correlated with UM/CR (r =0.227, p=0.002). A cut-off level of 43.8 ng/ml u-PDX showed 73.3% sensitivity and 93.3% specificity to detect DN in early stage. A cut-off level of 30 mg/g UM/CR showed 41.5% sensitivity and 90% specifity in predicting DN. u-PDX was elevated in 48,2% of normoalbuminuric patients.Conclusion: Urinary podocalyxin be useful and more sensitive and specific marker in early detection of DN than microalbuminuria.

Effects of SGLT2 inhibitors on patients with diabetic kidney disease: A preliminary study on the basis of podocyturia

“…7 Presence of podocyturia has also been reported previously in patients with DKD. 7,[44][45][46] Furthermore, our previous study (submitted paper under review) confirms the main findings consistent with the literature in a larger diabetic patient group.…”

“…Nakamura et al identified podocytes in the urine of patients with micro‐ and macroalbuminuria, and it was also thought that depending on the severity of glomerular damage, the level of podocyturia can change 7 . Presence of podocyturia has also been reported previously in patients with DKD 7,44‐46 . Furthermore, our previous study (submitted paper under review) confirms the main findings consistent with the literature in a larger diabetic patient group.…”

Assessment of Serum Podocalyxin as a Biomarker for Diabetic Nephropathy in Type 2 Diabetes patients in Duhok City

“…An important finding of the present study was that the case group had higher S.PCX levels than the control group. Similar results were found by (Kostovska et al, 2020;Shelbaya et al, 2020), who reported that urinary podocalyxin (U.PCX) levels were higher in diabetic patients. In addition, higher S.PCX levels were found in patients with macroalbuminuria than in those with normoalbuminuria and microalbuminuria but statistically not significant.…”

“…DN is a leading cause of the end-stage renal disease (ESRD) and is defined clinically by elevated urinary albumin excretion or/and the presence of impaired renal function (Barutta et al, 2021). Besides increased albuminuria and a decreased estimated glomerular filtration rate (eGFR), the two common indicators of DN (Cole and Florez, 2020), some studies have confirmed the existence of a new biomarker called podocalyxin (Shoji et al, 2016;Kostovska et al, 2020;Shelbaya et al, 2020;Ghorab et al, 2020;Xie et al, 2021). They measured podocalyxin levels in the urine and confirmed its positive correlation with UACR.…”

A pilot study of changes in urinary podocalyxin levels during normal pregnancy and labor

“…(7) [8] [9] [10][11] [12] [13][14].The molecular weight of the peptide bone of podocalyxin is 55 kDa which is 200 kDa with heavy glycosylation. Serum podocalyxin (likely derived from maternal endothelial cells) levels increase throughout pregnancy, and it is possible that the non-glycosylated form can be filtered through the glomerular filtration barrier when higher serum levels are present, resulting in increased urinary excretion [15].…”