Association of Urinary Inflammatory Markers and Renal Decline in Microalbuminuric Type 1 Diabetics

Progressive renal function decline begins in one third of patients with microalbuminuria and type 1 diabetes. This study examined whether this decline is associated with elevated excretion of inflammatory markers in urine. Five inflammatory markers (IL-6, IL-8, monocyte chemoattractant protein-1, in...

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Published in:	Journal of the American Society of Nephrology 2008-04, Vol.19 (4), p.789-797
Main Authors:	WOLKOW, Pawel P, NIEWCZAS, Monika A, PERKINS, Bruce, FICOCIELLO, Linda H, LIPINSKI, Boguslaw, WARRAM, James H, KROLEWSKI, Andrzej S
Format:	Article
Language:	eng
Subjects:	Adult Albuminuria - complications Albuminuria - urine Biological and medical sciences Biomarkers - urine Chemokines - urine Clinical Research Cytokines - urine Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - urine Diabetes. Impaired glucose tolerance Diabetic Nephropathies - complications Diabetic Nephropathies - urine Disease Progression Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Humans Inflammation - urine Male Medical sciences Nephrology. Urinary tract diseases Pilot Projects
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Summary:	Progressive renal function decline begins in one third of patients with microalbuminuria and type 1 diabetes. This study examined whether this decline is associated with elevated excretion of inflammatory markers in urine. Five inflammatory markers (IL-6, IL-8, monocyte chemoattractant protein-1, interferon-gamma-inducible protein (IP-10), and macrophage inflammatory protein-1delta) were measured in urine samples from the First Joslin Study of the Natural History of Microalbuminuria in Type 1 Diabetes, a cohort recruited in 1991. Samples were obtained from 43 participants with microalbuminuria and stable renal function (nondecliners), from 28 with microalbuminuria and early progressive renal function decline (decliners), and from 74 with normoalbuminuria and stable renal function (reference). Urinary concentrations of all five inflammatory markers were significantly higher in decliners than in nondecliners, who were similar to the reference group. Multivariate analysis revealed that those with more than two markers elevated were more than five times as likely to have early progressive decline of renal function. In contrast, serum concentrations of C-reactive protein, IL-8, and macrophage inflammatory protein-1delta did not differ between decliners and nondecliners. These results support the hypothesis that inflammatory processes in the kidney contribute to the progression of nephropathy in patients with type 1 diabetes.
ISSN:	1046-6673 1533-3450