الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease (CKD) is a major health problem because of its
association with a high cardiovascular risk, and most CKD patients progress to endstage
renal disease (ESRD), requiring dialysis or transplantation. Type 2 diabetes
mellitus is one of the most important risk factors in the development of CKD, around
30%–50% of ESRD patients worldwide come from a diabetic origin.
Although Diabetic nephropathy is the leading cause of renal failure requiring
renal replacement therapy worldwide but effective methods to identify and halt
progression of pathophysiological changes of Diabetic nephropathy remain elusive.
Current Diabetic nephropathy diagnosis and monitoring of disease progression
rely heavily on the detection of urinary microalbuminuria. Tissue damage and induction
of inflammation have already occurred by the time that microalbuminuria is detectable.
Furthermore, microalbuminuria is not specific to Diabetic nephropathy but is merely a
hallmark of glomerular, and more specifically podocyte dysfunction.
One important problem is the growing number of DN patients, which highlights
the urgent need for novel biomarkers that allow an earlier diagnosis of renal damage, as
well as the identification of patients that rapidly progress to ERSD.
This work was conducted to study role of serum MicroRNA in comparison with
serum Neutrophil gelatinase-associated lipocalin for early detection of diabetic
nephropathy in type 2 diabetic Egyptian patients.
This study was conducted in Suez hospital of insurance from the patients
admitted to the Internal Medicine Outpatients Clinics. This study followed the ethical
standards of our hospital. Informed consent was obtained from all participants.
Study Groups:
group (I): 15 healthy persons with no diabetes mellitus as well as age, sex, and
ethnic origin matched to the patients.
group (II): 15 patients diagnosed type 2 diabetes mellitus with normal albumin
excretion (albumin/ creatinine ratio < 30 mg/g)
group (III): 15 patints with diabetic nephropathy, assessed by using albumin to
creatinine ratio in spot urine sample albuminuria (ACR > 30 mg/g).
ExcIusion criteria were used for all subjects:
1. Type 1 diabetic patients
2. Patient with congestive heart failure
3. Pregnancy
4. Malignancy
5. Infection.
All participants were subjected to the following:
1- History taking.
2- Complete physical examination.
Summary
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3- Fasting blood glucose, 2h post prandial blood glucose.
4- Glycated hemoglobin (HbAlc).
5- Total cholesterol, HDLc, LDLc, TAG.
6- Urine albumin to creatinine ratio in spot urine sample.(testing for ACR was repeated
twice 3 months apart if the first sample was positive for microalbuminuria, patients
have been instructed to refrain from heavy exercise 24 h before the test.)
7- Serum urea and creatinine
8- Serum microRNA
9- Serum Neutrophil gelatinase-associated lipocalin (NGAL)
The results of the present study revealed the following:
The study showed that the miR-192&NGAL levels were significantly higher in
patients diagnosed type 2 diabetes mellitus with albuminuria in comparison with
patients diagnosed type 2 diabetes mellitus without albuminuria. There was significant
positive correlation between MicroRNA-192& NGAL and Alb/CR.