Cystatin-C and TGF-Beta levels in patients with diabetic nephropathy

espanolObjetivo: Evaluar la insuficiencia renal en pacientes con diabetes tipo 2 con normoalbuminuria o microalbuminuria mediante la deteccion de la concentracion de cistatina C en suero y de TGF- en suero y orina. Metodos: Estudio transversal realizado en el Departamento de Endocrinologia de la Facultad de Medicina de la Universidad de Baskent. En el estudio, se incluyo a pacientes con diabetes mellitus tipo 2 sin nefropatia diabetica manifiesta conocida. Los pacientes seleccionados se estratificaron en 4 grupos, agrupados en terminos de edad, sexo, grado de microalbuminuria y filtracion glomerular estimada (FGe) calculada mediante la formula MDRD. Resultados: Se incluyo a 78 pacientes. Se clasificaron en 4 grupos dependiendo de la excrecion urinaria de albumina y de la FGe. Se observo que la complicacion macrovascular era mayor en los pacientes con microalbuminuria que en otros (p Conclusiones: Aunque se recomienda la excrecion urinaria de albumina para la deteccion de la nefropatia diabetica tipo 2, hay un grupo de pacientes con disminucion de la FGe, pero sin aumento de la excrecion urinaria de albumina, en los que estaba indicado usar la concentracion de cistatina C en suero como un biomarcador temprano de nefropatia diabetica. EnglishObjective: To evaluate renal impairment in type 2 diabetic patients with normoalbuminuria or microalbuminuria by detection of serum cystatin C and serum and urinary TGF- levels. Methods: Cross-sectional study conducted at the Department of Endocrinology in Baskent University School of Medicine. Patients with type 2 diabetes mellitus without known overt diabetic nephropathy were included in the study. Recruited patients were stratified into four groups, matched in terms of age, gender, microalbuminuria level and estimated GFR calculated with MDRD. Results: 78 patients were enrolled. They were categorized into four groups depending on their urinary albumin excretion and estimated glomerular filtration rate. Macrovascular complication was found to be higher in patients with microalbuminuria than in other patients (p Conclusions: Although urinary albumin excretion is recommended for the detection of type two diabetic nephropathy, there is a group of patients with decreased eGFR but without increased urinary albumin excretion, in which serum cystatin C level was indicated to be used as an early biomarker of diabetic nephropathy.