Int J Nephrol. 2018 Apr 29;2018:6753489. doi: 10.1155/2018/6753489. eCollection 2018.

Undiagnosed Kidney Injury in Uninsured and Underinsured Diabetic African American Men and Putative Role of Meprin Metalloproteases in Diabetic Nephropathy.

International journal of nephrology

Lei Cao, Rashin Sedighi, Ava Boston, Lakmini Premadasa, Jamilla Pinder, George E Crawford, Olugbemiga E Jegede, Scott H Harrison, Robert H Newman, Elimelda Moige Ongeri

PMID: 29854459 PMCID: PMC5949186 DOI: 10.1155/2018/6753489

Abstract

Diabetes is the leading cause of chronic kidney disease. African Americans are disproportionately burdened by diabetic kidney disease (DKD) and end stage renal disease (ESRD). Disparities in DKD have genetic and socioeconomic components, yet its prevalence in African Americans is not adequately studied. The current study used multiple biomarkers of DKD to evaluate undiagnosed DKD in uninsured and underinsured African American men in Greensboro, North Carolina. Participants consisted of three groups: nondiabetic controls, diabetic patients without known kidney disease, and diabetic patients with diagnosed DKD. Our data reveal undiagnosed kidney injury in a significant proportion of the diabetic patients, based on levels of both plasma and urinary biomarkers of kidney injury, namely, urinary albumin to creatinine ratio, kidney injury molecule-1, cystatin C, and neutrophil gelatinase-associated lipocalin. We also found that the urinary levels of meprin A, meprin B, and two kidney meprin targets (nidogen-1 and monocytes chemoattractant protein-1) increased with severity of kidney injury, suggesting a potential role for meprin metalloproteases in the pathophysiology of DKD in this subpopulation. The study also demonstrates a need for more aggressive tests to assess kidney injury in uninsured diabetic patients to facilitate early diagnosis and targeted interventions that could slow progression to ESRD.

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Publication Types

• Journal Article

Grant support

• S10 OD018164/OD/NIH HHS/United States
• SC1 GM118271/GM/NIGMS NIH HHS/United States
• SC3 GM102049/GM/NIGMS NIH HHS/United States
• U54 MD008621/MD/NIMHD NIH HHS/United States