Photo Credit: Mohammed Haneefa Nizamudeen

The following is a summary of “Urinary podocyte stress marker as a prognostic indicator for diabetic kidney disease,” published in the January 2024 issue of Nephrology by Zeng et al.

Researchers conducted a retrospective study investigating the potential of urinary podocyte stress markers, like podocin and nephrin mRNA ratio, as prognostic indicators for diabetic kidney disease (DKD) progression toward end-stage kidney disease (ESKD).

They involved 118 patients with biopsy-confirmed DKD and 13 non-diabetic controls. Urinary mRNA levels of nephrin, podocin, and aquaporin-2 (AQP2) were evaluated. Renal events, including death, dialysis, or a 40% GFR reduction, were assessed at 12 months.

The results showed that the urinary podocin, nephrin mRNA ratio in DKD significantly surpassed that of the control group (P=0.0019). However, urinary nephrin, AQP2, or podocin: AQP2 ratios did not differ between groups. In DKD, the urinary podocin: nephrin mRNA ratio correlated with the seriousness of tubulointerstitial fibrosis (r = 0.254, P=0.006) and was linked to renal event-free survival at 12 months (unadjusted HR, 1.523; 95% CI 1.157–2.006; P=0.003). After adjustments, the urinary podocin: nephrin mRNA ratio trended in predicting renal event-free survival (adjusted HR, 1.327; 95% CI 0.980–1.797; P=0.067) but did not reach significance.

Investigators concluded that in biopsied DKD, podocin: nephrin mRNA hinted at prognosis but needs further study for broader use. Glomerular hope flickers, but definitive non-invasive DKD markers remain elusive.

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03471-8