Diabetic Retinopathy Clinical Trial
Official title:
Microalbuminuria as a Cardiovascular Risk Factor (PRECISED Substudy)
Microalbuminuria (MA) is an independent cardiovascular risk factor in diabetic and
non-diabetic subjects.
However, in the setting of type 2 diabetes, microalbuminuria could be a marker of either
early diabetic nephropathy or diffuse endothelial dysfunction. At present, there are no
biomarkers that permit us to discriminate between these two conditions.
A hypothesis free approach by using proteomic/metabolomic analyses in the urine samples of
selected populations seems an appropriate approach by which to explore this issue. In
addition, a driven hypothesis in the same groups of patients based on a sensitive marker of
kidney injury also seems appropriate.
Urinary levels of KIM-1(Kidney Injury Molecule-1 ) have been found elevated in experimental
diabetic nephropathy even before that MA . In addition, urinary levels of KIM-1 were found
significantly elevated in type 1 diabetic patients with MA, in comparison with diabetics with
normoalbuminuria and non-diabetic healthy controls. Moreover, low urinary KIM-1 levels at
baseline were associated with the regression of MA during a follow-up of 2 years . Therefore,
it could be hypothesized that the presence of MA + KIM-1 in urine samples would indicate
renal injury rather than endothelial dysfunction.
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