Early acute kidney injury biomarkers study in type 2 diabetes

• Grant number: 14/04596-8
• Support Opportunities: Regular Research Grants
• Duration: November 01, 2014 - October 31, 2015
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Fernando Luiz Affonso Fonseca
• Grantee: Fernando Luiz Affonso Fonseca
• Host Institution: Faculdade de Medicina do ABC (FMABC). Organização Social de Saúde. Fundação do ABC. Santo André , SP, Brazil
• Associated researchers: Marcelo Rodrigues Bacci

Abstract

Chronic renal failure is a prevalent disease in the world and especially in Brazil due to the high rate of diabetes in the population . Thus , measures enabling prevention of diabetes and chronic kidney disease and its diagnosis at an early stage have great importance as health promotion .The diagnosis of chronic kidney disease based on biochemical and radiological parameters . The KDIGO CKD defined as a persistent change in glomerular filtration rate ( GFR ) for at least 3 months duration or longer having the change of renal echotexture seen on imaging . One of the ways to estimate renal function is through the use of formulas that estimate glomerular filtration rate using demographic data such as gender , ethnicity and age as biochemical serum creatinine value .The most widely used and accepted as reliable for estimated GFR formula is the Modification of Diet of Renal Disease ( MDRD ) .Diabetic nephropathy is characterized by a state of hyperglycemia combined with glomerular inflammation , reduction of antioxidant protection and increased renal blood flow due to stimulation of the renin angiotensin aldosterone system and factors.The marker of renal disorder is reflected by the presence of albuminuria on urinalysis 24 hours or spot urine sample . The fraction albuminuria / creatinine is configured as a marker of poor renal and cardiovascular prognosis .Glycemic control is of paramount importance in the evolution of diabetic nephropathy and control factor is the persistent inflammatory stimulus is the deposition of glycation end products in the connective tissue (AGE ) . The glycosylated hemoglobin reliable factor in glycemic control during the life of the red cell and thus 3-4 months before the moment of sampling . Their result , however, may be affected by changes in the amount of hemoglobin as isolated anemia and hemoglobinopathies . The A1c fraction is the fraction of hemoglobin more reliable and trustworthy and capable of less influence of the variation of its concentration.The purpose of the paper is therefore to study , taking into account the fraction of glycated hemoglobin that patients with diabetes have type 2 , the presence of impaired renal function through protein markers such as beta trace protein , beta 2 microglobulin , neutrophil gelatinase -associated lipocalin ( NGAL ) , cystatin C in urine compared to the amount of albuminuria . Serum will compare the values of proinflammatory cytokines such as interleukin 6, tumor necrosis factor ( TNF) , fibroblast growth factor 23 and the classic parameters such as creatinine and urea.The patients are divided into 3 groups according to the range of glycated hemoglobin (> 7 %, 7-9 % and> 9%) and reap the blood sample and urine samples for the assessment of biochemical parameters . Patients with type 2 diabetes with at least 5 years of diagnosis and excluded patients on hemodialysis will be included with established chronic kidney disease according to the criteria of KDIGO , infection within 30 days of the interview , patients with hemoglobinopathies and cause of kidney injury that does not diabetes (AU)

Scientific publications

(4)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

BACCI, MARCELO R.; CHEHTER, ETHEL Z.; AZZALIS, LIGIA A.; DE AGUIAR ALVES, BEATRIZ COSTA; FONSECA, FERNANDO L. A.. Serum NGAL and Cystatin C Comparison With Urinary Albumin-to-Creatinine Ratio and Inflammatory Biomarkers as Early Predictors of Renal Dysfunction in Patients With Type 2 Diabetes. KIDNEY INTERNATIONAL REPORTS, v. 2, n. 2, p. 152-158, MAR 2017. (14/04596-8)

RODRIGUES, KELLY B.; FONSECA, FERNANDO L. A.; FERNANDES, JULIO C. B.. A Potentiometric Sensor Based on a Copper(II) Ion Composite for Vitamin C Determination in Urine. JOURNAL OF ANALYTICAL CHEMISTRY, v. 75, n. 8, p. 1086-1093, AUG 2020. (14/04596-8)

BACCI, MARCELO RODRIGUES; AGUIAR ALVES, BEATRIZ DA COSTA; CAVALLARI, MARINA ROMERA; AZZALIS, LIGIA AJAIME; DE ROZIER-ALVES, ROSS MARTIN; PEREZ, MATHEUS MOREIRA; CHEHTER, ETHEL ZIMBERG; PEREIRA, EDIMAR CRISTIANO; AFFONSO FONSECA, FERNANDO LUIZ. Urinary beta-trace protein gene expression analysis in type 2 diabetes mellitus patients. Einstein (São Paulo), v. 15, n. 4, p. 441-444, OCT-DEC 2017. (14/04596-8)

BACCI, MARCELO RODRIGUES; AGUIAR ALVES, BEATRIZ DA COSTA; CAVALLARI, MARINA ROMERA; AZZALIS, LIGIA AJAIME; DE ROZIER-ALVES, ROSS MARTIN; PEREZ, MATHEUS MOREIRA; CHEHTER, ETHEL ZIMBERG; PEREIRA, EDIMAR CRISTIANO; AFFONSO FONSECA, FERNANDO LUIZ. Urinary beta-trace protein gene expression analysis in type 2 diabetes mellitus patients. Einstein (São Paulo), v. 15, n. 4, p. 4-pg., 2017-10-01. (14/04596-8)