N-Acetyl-seryl-aspartyl-lysyl-proline is a potential biomarker of renal function in normoalbuminuric diabetic patients with eGFR ≥ 30 ml/min/1.73 m2

• Published in: Clinical and experimental nephrology 2019-08, Vol.23 (8), p.1004-1012
• Main Authors: Nitta, Kyoko, Nagai, Takako, Mizunuma, Yuiko, Kitada, Munehiro, Nakagawa, Atsushi, Sakurai, Masaru, Toyoda, Masao, Haneda, Masakazu, Kanasaki, Keizo, Koya, Daisuke
• Format: Article
• Language: English
• Subjects: Biomarkers; Creatinine; Diabetes; Diabetes mellitus; Diabetic nephropathy; Epidermal growth factor receptors; Medicine; Medicine & Public Health; Nephrology; Original Article; Proline; Renal function; Urine; Urology; β2 Microglobulin
• ISSN: 1342-1751; 1437-7799
• DOI: 10.1007/s10157-019-01733-6

Background A biomarker, by which we can predict alterations of renal function in normoalbuminuric diabetic patients, is not available. Here, we report that endogenous anti-fibrotic peptide N -acetyl-seryl-aspartyl-lysyl-proline (AcSDKP) represents a potential biomarker to predict alterations in eGFR in normoalbuminuric diabetic patients. Methods We analyzed 21 normoalbuminuric diabetic patients with eGFR ≥ 30 ml/min/1.73 m 2 and measured AcSDKP levels in first morning void urine. We divided patients into two groups based on the median values: low or high urinary AcSDKP groups (uAcSDKP/Cr low or uAcSDKP/Cr high ). At baseline, no significant differences in sex, age, HbA1c, BMI, serum creatinine levels, etc., were observed between the two groups. Results During ~ 4 years, the alteration in eGFR [ΔeGFR op (ΔeGFR observational periods)] was significantly stable in uAcSDKP/Cr high group compared with uAcSDKP/Cr low group over time ( P  = 0.003, χ 2  = 8.58). We also evaluated urine kidney injury molecule-1 (uKim-1) levels and found that ΔeGFR op was also stable in low uKim-1 group compared with high uKim-1 group over time ( P  = 0.004, χ 2  = 8.38). Patients who fulfilled the criteria for both uAcSDKP/Cr high and uKim-1 low exhibited stable ΔeGFR op ( P