Some biochemical and immunological aspects in patients with type 2 diabetic nephropathy

Diabetic mellitus (DM) is a metabolic disorder group of carbohydrate metabolism in which glucose is underused, producing hyperglycemia. Different statistics have led to diabetes being described as one of the main threat to human health in the 21 P st P  century. DM is the major cause of renal morbidity and mortality, and diabetic nephropathy is a leading cause chronic kidney failure. This study aimed to asses of different biochemical and immunological markers in diabetic patients with renal impairment and to find out the tests that can assess the renal function in those patients. Forty –five Type 2 diabetic nephropathy patients attending to the Abd- Almajid private hospital between December 2013 and July 2014 were recruited for this study. For the purpose of comparison, twenty –nine control subjects matched for age were also included. The patients were characterized by microcalbuminuria or increase in serum creatinine above the normal reference and history of diabetes which refers to early stage of diabetic nephropathy.Random  blood  glucose (RBG), total cholesterol (TC), HDLcholestrol,LDL-cholesterol,triglyceride (TG), glycosylated hemoglobin (HbA1c),  urea, creatinine , immunoglobulins and some inflammatory markers were measured in blood . Microalbumin , creatinine and ceruloplasmin were measured in urine .The results demonstrated a significant increase glycosylated hemoglobin ,RBG , blood urea , s.creatinine and decrease in eGFR in Type 2 diabetic nephropathy patients compared with healthy control.The high – sensitive  C-reactive  protein (hs-CRP)  showed a significant increase in type 2 diabetic nephropathy patients in comparison with healthy control ( 32.63 mg/dl vs 11.76 mg/dl) .The Transforming growth factor –beta 1 (TGF- β1) and tumor necrosis factor – alpha (TNF –α ) showed a non significant difference between the type 2 diabetic nephropathy and healthy control. Urine markers including microalbumin and ceruloplasmin showed a significant increase in level in Type 2 diabetic nephropathy patients
when compared with the healthy control.In conclusion, the study suggests that hyperglycemia and advanced glycation end product could increase the kidney damage. hs-CRP ,microalbumin and ceruloplasmin could be a good markers for the assessment of early kidney damage.