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CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(01): 001-004
DOI: 10.4103/JLP.JLP_164_17
Review Article

Urinary N-acetyl-beta-d-glucosaminidase levels in diabetic adults

Eiya Bibiana Omozee
Department of Physiology, University of Benin, Benin City, Nigeria
,
Enajit Ibiene Okaka
Department of Medicine, University of Benin, Benin City, Nigeria
,
Andrew Efosa Edo
Department of Medicine, University of Benin, Benin City, Nigeria
,
Leonard Fedinard Obika
Department of Physiology, University of Benin, Benin City, Nigeria
› Institutsangaben Financial support and sponsorship: Nil
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Abstract

Diabetes mellitus (DM) is known to be one of the most common causes of end-stage renal disease. The disease is usually not detected on time, because of the large functioning reserve of the kidney. Currently used markers (serum creatinine, creatinine clearance, urea, and electrolytes) remain relatively normal even when more than 50% of the renal nephron is not functioning. The aim of this study was to determine the level of urinary N-acetyl-beta-d-glucosaminidase (NAG) in diabetic adults in comparison with some currently used markers. A total of 56 diabetic patients between the ages of 23 and 63 were used for this study and 30 nondiabetic between the ages of 18 and 62 were used as control. The diabetic patients were classified into three groups based on how long they have been diagnosed: <2 years (25), 2–5 years (30), and >5 years (25). Spot midstream urine samples were collected into sterile containers, and blood samples were collected into plain tubes. All the analyses were done spectrophotometrically. Creatinine clearance was calculated using the Cockcroft–Gault Equation. There was a significant increase (P < 0.01) in NAG values of 2–5 years and above 5 years and control. The urinary microalbumin concentration of controls was significantly different (P < 0.05) only with those who have had DM for <2 years. Urinary creatinine concentration of control was significantly higher (P < 0.05) than values of all the diabetic groups. There was a significant increase (P < 0.01) in creatinine clearance of control group and those who have had DM for <2 years. It is thus concluded that urinary NAG can be used as an early marker in the diagnosis of diabetic nephropathy since urinary NAG increases first before the other markers analyzed in this current study begins to increase.

Key words

Creatinine clearance - diabetic nephropathy - microalbumin - N-acetyl-beta-d-glucosaminidase


Publikationsverlauf

Eingereicht: 01. November 2017

Angenommen: 31. Januar 2018

Artikel online veröffentlicht:
06. April 2020

© 2019.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 United States Renal Data System: Annual Data Report, National Institute of Diabetes and Digestive and Kidney Disease. National Institute of Health United States America; 2007.
  • 2 National Institute of Diabetes and Digestive and Kidney diseases: Diabetes Statistics, National Institute of Diabetes and Digestive and Kidney Disease National Institute of Health. United States of America; 2007.
  • 3 Sidney KD, Shreeram A. Preventing progression and complications of renal disease. Hosp Med 1997;33:11-2
  • 4 Hewitt SM, Dear J, Star RA. Discovery of protein biomarkers for renal diseases. J Am Soc Nephrol 2004;15:1677-89.
  • 5 Gibb DM, Tomlinson PA, Dalton NR, Turner C, Shah V, Barratt TM, et al. Renal tubular proteinuria and microalbuminuria in diabetic patients. Arch Dis Child 1989;64:129-34.
  • 6 Price RG. The role of NAG (N-acetyl-beta-D-glucosaminidase) in the diagnosis of kidney disease including the monitoring of nephrotoxicity. Clin Nephrol 1992;38 Suppl 1:S14-9.
  • 7 Bartels H, Böhmer M, Heierli C. Serum creatinine determination without protein precipitation. Clin Chim Acta 1972;37:193-7.
  • 8 Feldt-Rasmussen B, Borch-Johnsen K, Deckert T, Jensen G, Jensen JS. Microalbuminuria: An important diagnostic tool. J Diabetes Complications 1994;8:137-45.
  • 9 Price RG. Measurement of N-acetyl-beta-glucosaminidase and its isoenzymes in urine methods and clinical applications. Eur J Clin Chem Clin Biochem 1992;30:693-705.
  • 10 Uslu S, Efe B, Alataş O, Kebapçi N, Colak O, Demirüstü C, et al. Serum cystatin C and urinary enzymes as screening markers of renal dysfunction in diabetic patients. J Nephrol 2005;18:559-67.
  • 11 D’Amico G, Bazzi C. Urinary protein and enzyme excretion as markers of tubular damage. Curr Opin Nephrol Hypertens 2003;12:639-43.
  • 12 Kordonouri O, Hartmann R, Müller C, Danne T, Weber B. Predictive value of tubular markers for the development of microalbuminuria in adolescents with diabetes. Horm Res 1998;50 Suppl 1:23-7.
  • 13 Kato H, Takashima T, Kishikawa H, Emura S, Ohmori K. The significance of urinary N-acetyl-beta-D-glucosaminidase for predicting early stage diabetic nephropathy. Int J Clin Pract 1997;51:489-90.
  • 14 Basturk T, Altuntaş Y, Kurklu A, Aydin L, Eren N, Unsal A, et al. Urinary N-acetyl B glucosaminidase as an earlier marker of diabetic nephropathy and influence of low-dose perindopril/indapamide combination. Ren Fail 2006;28:125-8.
  • 15 Vaidya VS, Niewczas MA, Ficociello LH, Johnson AC, Collings FB, Warram JH, et al. Regression of microalbuminuria in type 1 diabetes is associated with lower levels of urinary tubular injury biomarkers, kidney injury molecule-1, and N-acetyl-β-D-glucosaminidase. Kidney Int 2011;79:464-70.
  • 16 Dalla Vestra M, Saller A, Bortoloso E, Mauer M, Fioretto P. Structural involvement in type 1 and type 2 diabetic nephropathy. Diabetes Metab 2000;26 Suppl 4:8-14.
  • 17 Abdel Shakour S, el-Hefnawy H, el-Yamani MY, Azmi Y. Urinary N-acetyl-beta-D-glucosaminidase in children with diabetes as an early marker of diabetic nephropathy. East Mediterr Health J 2002;8:24-30.