Urinary adiponectin excretion is an early predictive marker of the decline of the renal function in patients with diabetes mellitus

Aims: Since diabetes-associated kidney complication changes from diabetic nephropathy to diabetic kidney disease (DKD), more suitable biomarkers than urinary albumin are required. It has been hypothesized that urinary adiponectin (u-ADPN) is associated with the progression of DKD. We therefore evaluated the effectiveness of u-ADPN in predicting the decline of the renal function in patients with diabetes prior to end-stage renal disease. Methods: An ultrasensitive immune complex transfer enzyme immunoassay (ICT-EIA) was used to measure total and high molecular weight (HMW) adiponectin separately. We evaluated the relationships between the creatinine-adjusted urinary total-ADPN and HMW-ADPN, albumin (UACR) and liver-type fatty acid binding protein (L-FABP) at baseline and the 2-year change of the estimated glomerular filtration rate (Delta eGFR). Results: This 2-year prospective observational study included 201 patientswith diabetes. These patients were divided into three groups according to their Delta eGFR: <=-10 mL/min/1.73 m(2), >-10 and <= 0 mL/min/1.73 m(2), and > 0 mL/min/1.73 m(2). Jonckheere-Terpstra test showed that lower.eGFR was associated with higher u-HMW-ADPN (p = 0.045). In logistic regression analysis, u-HMW-ADPN was associated with.eGFR after adjusted age, sex, and basal eGFR. Conclusion: Urinary HMW-ADPN could predict a declining renal function in patients with diabetes. (c) 2021 Elsevier Inc. All rights reserved.

Automated summary

This study aimed to evaluate the effectiveness of urinary adiponectin as a biomarker for predicting the decline of renal function in patients with diabetes. The results showed a positive correlation between urinary high molecular weight adiponectin and declining renal function in diabetic patients.