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Title: Use of Readily Accessible Inflammatory Markers to Predict Diabetic Kidney Disease.
Austin Authors: Winter, Lauren;Wong, Lydia A;Jerums, George ;Seah, Jas-Mine ;Clarke, Michele V;Tan, Sih Min;Coughlan, Melinda T;MacIsaac, Richard J;Ekinci, Elif I 
Affiliation: Endocrine Centre of Excellence, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia
Department of Endocrinology and Diabetes, St Vincent's Health, Melbourne, Victoria, Australia
Department of Medicine, St Vincent's Health, University of Melbourne, Melbourne, Victoria, Australia
Issue Date: 2018
Date: 2018
Publication information: Frontiers in endocrinology 2018; 9: 225
Abstract: Diabetic kidney disease is a common complication of type 1 and type 2 diabetes and is the primary cause of end-stage renal disease in developed countries. Early detection of diabetic kidney disease will facilitate early intervention aimed at reducing the rate of progression to end-stage renal disease. Diabetic kidney disease has been traditionally classified based on the presence of albuminuria. More recently estimated glomerular filtration rate has also been incorporated into the staging of diabetic kidney disease. While albuminuric diabetic kidney disease is well described, the phenotype of non-albuminuric diabetic kidney disease is now widely accepted. An association between markers of inflammation and diabetic kidney disease has previously been demonstrated. Effector molecules of the innate immune system including C-reactive protein, interleukin-6, and tumor necrosis factor-α are increased in patients with diabetic kidney disease. Furthermore, renal infiltration of neutrophils, macrophages, and lymphocytes are observed in renal biopsies of patients with diabetic kidney disease. Similarly high serum neutrophil and low serum lymphocyte counts have been shown to be associated with diabetic kidney disease. The neutrophil-lymphocyte ratio is considered a robust measure of systemic inflammation and is associated with the presence of inflammatory conditions including the metabolic syndrome and insulin resistance. Cross-sectional studies have demonstrated a link between high levels of the above inflammatory biomarkers and diabetic kidney disease. Further longitudinal studies will be required to determine if these readily available inflammatory biomarkers can accurately predict the presence and prognosis of diabetic kidney disease, above and beyond albuminuria, and estimated glomerular filtration rate.
DOI: 10.3389/fendo.2018.00225
ORCID: 0000-0003-2372-395X
Journal: Frontiers in endocrinology
PubMed URL: 29910771
ISSN: 1664-2392
Type: Journal Article
Subjects: atherosclerosis
diabetic kidney disease
diabetic nephropathy
neutrophil–lymphocyte ratio
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