Abstract
Background: Diabetic Kidney Disease (DKD) represents the major cause Chronic Kidney Disease (CKD) where 5- 40% of patients with Type 2 Diabetes Mellitus (T2DM) ultimately develop DKD. CKD diagnosis is reliable on levels of blood urea nitrogen and serum creatinine, however, serum creatinine has a low predictive value in early detection of renal impairment. So, new biomarkers for early diagnosis of CKD is of interest. Objectives: Elucidate the significance of Neutrophil Gelatinase- Associated Lipocalin (NGAL) as an early predictor of diabetic nephropathy in comparison with albuminuria in (T2DM). Patients and Methods: Prospective, case control study, carried out on patients with T2DM with a duration of disease ranged from (5-15) years, presented to outpatient clinics of nephrology and endocrinology units of internal medicine department in Zagazig University hospitals from August 2018 to February 2019., The study included (100) participants divided into : group (A) 25 healthy control , group (B) 75 diabetic type 2 patients stratified into three subgroups according to albumin / creatinine ratio: subgroup (1) : 25 normoalbuminuric ,subgroup (2): 25 microalbuminuric subgroup (3) : 25 macroalbuminuric. Results: there was statistically significant difference between healthy individuals, normo, micro and macroalbuminuria diabetic patients regarding serum NGAL (sNGAL) & urinary NGAL (uNGAL),where their levels incremented parallel to the degree of albuminuria . Conclusion: tubular injury may precede glomerular injury in diabetic patients and As NGAL is a tubular marker , So NGAL is superior to albumin / Creatinine ratio(ACR) as an early predictor of DKD among T2DM patients .