Kidney injury molecule-1 and neutrophil gelatinase associated lipocalin in normoalbuminuric diabetic children

Abstract

Background: We aimed at evaluating the urinary levels of kidney injury molecule-1 (KIM-1) and neutrophil gelatinase associated lipocalin (NGAL), and the relationship between these markers and clinical and laboratory variables in normoalbuminuric children with type 1 diabetes (T1D). Methods: The study group consisted of 60 (F/M: 28/32) children with T1D with a median age of 13 (min: 7.1-max: 17.9) years and a mean HbA(1c) of 8.6%. The average period of treatment was 6.8 +/- 2.2 years. The control group consisted of 60 healthy children [(F/M: 32/28); median age: 13.6 (min: 6.9-max: 17.9) years]. Results: Urinary KIM-1 and NGAL levels were significantly elevated in the diabetic group (KIM-1: 0.50 +/- 0.34 ng/mg-cr; NGAL: 33 +/- 31 ng/mg-cr) compared with the nondiabetic control subjects (KIM-1: 0.26 +/- 0.25 ng/mg-cr, NGAL 13.3 +/- 14.5 ng/mg-cr) (p<0.001). No significant associations were observed between NGAL or KIM-1 and the duration of diabetes and HbA(1c) levels. NGAL was found to be weakly correlated with KIM-1 (p<0.005, r=0.289). Conclusions: NGAL and KIM are high in normoalbuminuric diabetic children before reduction in glomerular filtration rate. High NGAL and KIM-1 levels may indicate early diabetic kidney injury; however, we did not observe any relationship between these markers and diabetic indices. For clinical usefulness of these markers, long-term studies are required.