Background: Diabetic nephropathy is acause of end-stage renal disease . Microalbuminuria is the gold standard for detection and prediction of diabetic kidney disease in clinical practice. However, microalbuminuria has several limitations, such as lower sensitive, larger variability. It is urgent to explore higher sensitivity and specificity for earlier detection of diabetic kidney disease and more accurate prediction of the progression to end stage renal disease.
Aim: to clarify whether urinary type IV collagen-to-creatinine ratio is a predictor for the incidence of microalbuminuria in patients with Type 1 diabetes.
Methodology: cross sectional study of 90 normoalbuminuric patients who had been diagnosed with Type 1 diabetes at least 5 years ago and who had been treated as outpatients attending the endocrine unit for follow up. The following investigations were done for all patients: (HbA1c), CBC ,Cholesterol ,serum creatinine ,Urea, GFR, Urinary albumin-to-creatinine ratio, urinary type IV collagen -to-creatinine ratio was measured basal at the beginning of the research in first-voided urine samples collected early in the morning on the day of the hospital visit and , Micro albumin in urine : measured at the beginning of the research and after 1year follow up
Results : patients were divided into two groups according to the median of urinary Type IV collagen/creatinine ratio (2.4 μg /g Cr).The urinary Type IV collagen/creatinine ratio was significantly high in above median group (2) (2.6-7.8 μg /g Cr) than below median group (1) (0.3-2.2 μg /g Cr) , Alb/Cr ratio after 1year was significantly high in group (2) (38.67±23.29) than group (1)(4.07±2.32), also Microalbumin after 1 year was significantly high in group (2) (33.07±13.16) than group (1) (13.67±4.29).
Conclusion: Urinary type IV collagen considered an early predictor for the development of microalbuminuria and diabetic nephropathy in patients with Type 1 diabetes .
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