T h e c l i n i c a l u t i l i t y o f u r i n a r y N - a c e t y l - β - D - glucosaminidase[NAG] creatinine ratio in the assessment of diabetic nephropathy in a tertiary hospital in Eastern Nigeria

Abstract

Tubular injury, as shown by the detection of tubular damage markers in the urine, is a critical component of the early course of Diabetic Nephropathy (DN). Urinary excretion of tubular markers such as urinary N- acetyl-β-D glucosaminidase (NAG) may be useful in assessing an initial malfunction or damage of the renal tubules in the early stage of DN. This study was to assess the clinical usefulness of NAG/creatinine ratio in evaluating kidney dysfunction in type 2 diabetes mellitus (DM) patients.This was a cross-sectional analytical study of 283 type 2 DMpatients at the Federal Medical Centre (FMC), Owerri, Nigeria. Ethical approval was obtained from the Research and Ethics Committee of FMC, Owerri. Data obtained was analyzed using IBM-SPSS version 21.0. A p-value of <0.05 was considered significant for all statistical comparisons.The mean age of patients studied was 56±13.41 years. Of the patients studied, 87 patients were normoalbuminuric while 196 had microalbuminuria. The mean NAG/creatinine ratio for normoalbuminuric diabetics was significantly lower (p<0.001) than values obtained in patients with microalbuminuria. In addition, 28.7% and 57.7% of normoabulminuric and microalbuminuric diabetics respectively had elevated urinary NAG/creatinine ratio.Higher Urinary NAG excretion in microalbuminuric diabetics represents an early marker of incipient diabetic nephropathy buttressing that early NAG excretion at elevated levels is a significant marker of susceptibility to DN and its assessment may help identify diabetics with predisposition to DN.