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Subject Area

Ophthalmology

Article Type

Original Study

Abstract

Objective To investigate urinary podocalyxin (PCX) and cyclophilin A (CypA) as useful markers for early detection of type 2 diabetic nephropathy (DN). Background PCX is a transmembrane protein that localizes to the apical cell of glomerular podocytes. PCX maintains podocytes shape. PCX is shed from injured podocytes into urine as small vesicles. CypA is an 18-kD protein that is distributed in the cytoplasm and facilitates protein folding and trafficking. It acts as a cellular receptor for cyclosporine A. The expression of CypA is quite high in the kidney, where proximal tubular epithelial cells contain more CypA than other kidney tissues. CypA was detected in diabetic patients' plasma and secreted by monocytes in response to hyperglycemia, indicating that CypA could be a potential secretory marker in type 2 DN. Patients and methods This case–control study was conducted at the Clinical Pathology Department of Menoufia University Hospitals from September 2017 to February 2018 on 66 type 2 diabetic patients and 20 healthy participants as a control group. They all underwent full history, clinical examination, routine renal functions, urinary creatinine and albumin, urinary albumin creatinine ratio, glycated hemoglobin (%), and quantification of urinary PCX and CypA by enzyme-linked immunosorbent assay. Results Urinary PCX/creatinine ratio and urinary CypA/creatinine ratio were highly significant (P < 0.001) in the patient group compared with the control group. Conclusion Urinary PCX and CypA may be markers for early stage of DN, with more specificity of CypA.

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