Can glomerular mRNAs in human type 1 diabetes be used to predict transition from normoalbuminuria to microalbuminuria?

Sharon G. Adler, Shin Wook Kang, Stella Feld, Dae Ryong Cha, Lilly Barba, Liliane Striker, Gary Striker, Bruce L. Riser, Janine LaPage, Cynthia C. Nast

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23 Citations (Scopus)

Abstract

Background: mRNAs of pathogenetic importance in the development of diabetic nephropathy were measured in subjects with type 1 diabetes to determine whether these might be used to predict progression from normoalbuminuria to microalbuminuria. We proposed that conversion from normoalbuminuria to microalbuminuria would be most likely in subjects whose connective tissue growth factor (CTGF) and collagen mRNAs were above the 95% confidence interval (CI) for live renal donors and within the 95% CI for subjects with abnormal albuminuria. Methods: Glomerular CTGF, collagen α2(IV), and control glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNAs were measured in microdissected glomeruli from living renal donors (n = 10), and subjects with normoalbuminuria (n = 12), microalbuminuria (n = 5), and overt proteinuria (n = 6). Results: After 44 ± 2 months of follow-up, one subject converted from normoalbuminuria to microalbuminuria. Although the data are limited, progression from normoalbuminuria to microalbuminuria occurred in the only normoalbuminuric subject whose mRNA levels were above the live renal donors' 95% CI for CTGF and collagen α2(IV) and within the 95% CI of subjects with abnormal albuminuria. No clinical or histopathologic finding distinguished the progressor from the nonprogressors at the time of biopsy. Conclusion: This case report provides proof-of-principle that a panel of glomerular mRNA markers chosen because of their pathogenetic relevance may be useful adjuncts to albuminuria and histology in predicting clinical stability or clinical progression in diabetic nephropathy. $ 2002 by the National Kidney Foundation, Inc.

Original languageEnglish
Pages (from-to)184-188
Number of pages5
JournalAmerican Journal of Kidney Diseases
Volume40
Issue number1
DOIs
Publication statusPublished - 2002 Jan 1

Keywords

  • Connective tissue growth factor (CTGF)
  • Diabetic nephropathy
  • Diagnostic test
  • Normoalbuminuria
  • Predictive test
  • Type IV collagen

ASJC Scopus subject areas

  • Nephrology

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    Adler, S. G., Kang, S. W., Feld, S., Cha, D. R., Barba, L., Striker, L., Striker, G., Riser, B. L., LaPage, J., & Nast, C. C. (2002). Can glomerular mRNAs in human type 1 diabetes be used to predict transition from normoalbuminuria to microalbuminuria? American Journal of Kidney Diseases, 40(1), 184-188. https://doi.org/10.1053/ajkd.2002.33928