Diabetic Nephropathy, Diabetic Retinopathy, Endothelial Dysfunction, Microalbuminuria
Conditions
Keywords
Type 1 Diabetic, Type 2 Diabetic, Hypertension, Renal Injury, Diabetic retinopathy
Brief summary
Microalbuminuria (MA) is an independent cardiovascular risk factor in diabetic and non-diabetic subjects. However, in the setting of type 2 diabetes, microalbuminuria could be a marker of either early diabetic nephropathy or diffuse endothelial dysfunction. At present, there are no biomarkers that permit us to discriminate between these two conditions.
Detailed description
A hypothesis free approach by using proteomic/metabolomic analyses in the urine samples of selected populations seems an appropriate approach by which to explore this issue. In addition, a driven hypothesis in the same groups of patients based on a sensitive marker of kidney injury also seems appropriate. Urinary levels of KIM-1(Kidney Injury Molecule-1 ) have been found elevated in experimental diabetic nephropathy even before that MA . In addition, urinary levels of KIM-1 were found significantly elevated in type 1 diabetic patients with MA, in comparison with diabetics with normoalbuminuria and non-diabetic healthy controls. Moreover, low urinary KIM-1 levels at baseline were associated with the regression of MA during a follow-up of 2 years . Therefore, it could be hypothesized that the presence of MA + KIM-1 in urine samples would indicate renal injury rather than endothelial dysfunction.
Interventions
OTHERnon intervention
Sponsors
Hospital Universitari Vall d'Hebron Research Institute
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients with diabetes mellitus type 2 with microalbuminuria with and without retinopathy. Control groups: diabetes mellitus type 1 with microalbuminuria and retinopathy hypertensive patients with microalbuminuria and diabetic patients with a renal biopsy
Exclusion criteria
* Patients without microalbuminuria or patients with macroalbuminuria
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To find markers for a better definition of the meaning of microalbuminuria | 3 years | Improve diagnosis of diabetic nephropathy |
| Complementary markers for improving the performance of MA | 3 years | Improve diagnosis of diabetic nephropathy |
Secondary
| Measure | Time frame |
|---|---|
| To identify candidates which could help to discriminate whether microalbuminuria is related to endothelial dysfunction rather than kidney damage | 3 years |
| To test whether the enhancement of this specific marker of kidney injury is able to identify those patients in which MA really means diabetic nephropathy. | 3 years |
Countries
Spain
Contacts
Primary ContactDavid Garcia-Dorado Garcia, PhD MD
Outcome results
None listed