We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
Technopath Clinical Diagnostics - An LGC Company


Beckman Coulter develops, manufactures and markets laboratory systems, reagents, centrifugation, lab automation, elec... read more Featured Products: More products

Download Mobile App


ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.
06 Feb 2023 - 09 Feb 2023

Urinary NAG-Creatine Ratio Predicts Advanced Diabetic Kidney Disease

By LabMedica International staff writers
Posted on 03 Jan 2023
Print article
Image: The AU5800 fully automated biochemical analyzer (Photo courtesy of Beckman-Coulter)
Image: The AU5800 fully automated biochemical analyzer (Photo courtesy of Beckman-Coulter)

Diabetes is the leading cause of chronic kidney disease and end-stage kidney disease worldwide and becomes one of the biggest healthcare challenges of the 21st century. Microvascular complications have been identified as the common and major diabetic complications.

Diabetic Kidney Disease (DKD) typically manifests a progressive deterioration of kidney function, and the increased glomerular filtration rate (GFR), glomerular hypertrophy, and excretion of urinary albumin are the major indicators. Various urine proteins may exhibit significant differences in diagnostic, predictive, and prognostic power for DKD.

Medical Scientists at the Suzhou Medical College of Soochow University (Suzhou, China) retrospectively analyzed a total of 117 patients with type 2 DKD, 83 males and 34 females, aged 37–85 years, including early and advanced stages and their laboratory parameters were statistically assessed. The patients were divided into two groups: early (stages IIa and IIb) and advanced (stages III and IV) groups based on the pathological grading.

The urine in spot time and whole 24 hours was obtained, and the fasting venous blood of patients were collected in vacutainer tubes. A BC-7500 automatic hematological analyzer (Mindray Inc, Shenzhen, China) was used to analyze the white blood cell (WBC), neutrophil (NEU), and high sensitive C reactive protein (HS-CRP). Multiple biochemical indexes were measured, which included serum creatine (sCR), serum urea (sUR), cholesterol (CHOL), homocysteine (HCY), thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), fibrinogen (FIB), and d-dimer (D-D).

The levels of urinary creatinine, N-acetyl-β-d-glucosaminidase (NAG), total protein (PRO), microalbumin (MA), immunoglobulin G (IgG), transferrin (TFR), and α1-microglobulin (α1MG) in spot urine, and albumin excretion (UAE) in 24 hour urine were measured by the AU5800 fully automated biochemical analyzer (Beckman-Coulter, Brea, CA, USA). Urinary N-acetyl-β-d-glucosaminidase (NAG) and proteins to creatinine ratios were calculated to present as NAG/CR, PRO/CR, albumin to creatine ratio (ACR), IgG/CR, TFR/CR, and α1MG/CR.

The investigators reported that N-acetyl-β-d-glucosaminidase-creatine (NAG/CR) level in advanced DKD was statistically higher than that in early DKD, and there was a higher incidence of advanced DKD (72% versus 56%) and high odds ratio (OR: 3.917) of NAG/CR with ≥2.79 U/mmol compared with <2.79 U/mmol. NAG/CR ratio also showed a higher area under the ROC curve of 0.727 with a high sensitivity (0.75) and a moderate specificity (0.66) when 1.93 U/mmol was set as the optimal cutoff value. The adjusted-multivariable analysis revealed that NAG/CR had an OR of 1.021 and 2.223 based on a continuous and categorical variable, respectively, for risk of advanced DKD. Moreover, the prevalence of advanced DKD exhibited an increasing tendency by an increment of the trisector of NAG/CR.

The authors concluded that NAG/CR ratio is an independent predictor for advanced DKD in type 2 diabetes (T2D) patients, and it also can be used as a powerful identifying marker between early and advanced DKD. The study was published on December 26, 2022 in the Journal of Clinical Laboratory Analysis.

Related Links:
Suzhou Medical College of Soochow University
Mindray Inc 

Gold Supplier
Pipette Tips
Sapphire Pipette Tips
Semi-Auto Microfluidic Immunofluorescent Analyzer
mLabs Smart
POCT Analyzer
Reagent Strips
Uriquest Plus I

Print article


Molecular Diagnostics

view channel
Image: A novel research study moves the needle on predicting sudden cardiac arrest (Photo courtesy of Pexels)

Newly Identified Protein Biomarkers in Blood Predict Sudden Cardiac Arrest Before it Strikes

Sudden cardiac arrest, or the sudden loss of heartbeat, is a life-threatening heart condition and often fatal. Despite providing an organized emergency medical response, less than 10% of individuals having... Read more


view channel
Image: Histopathology of Langerhans cell histiocytosis: The variation in nuclear contours of these cells is evident in this lesion. Classic `kidney bean` nuclei of Langerhans cells with a central groove are present (Photo courtesy of John Lazarchick, MD)

Cooperativity Between Myeloid Lineages Promotes Langerhans Cell Histiocytosis Pathology

Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasia seen in children and adults who present with lesions composed of pathologic variants of myeloid cells that share certain phenotypic... Read more


view channel
Image: Medical illustration of Carbapenem-resistant Enterobacteriacea (Photo courtesy of CDC, Stephanie Rossow)

Breakthrough Test Enables Targeted Antibiotic Therapy for Various Enterobacter Species

Bacteria of the Enterobacter genus are considered to be the most dangerous bacteria linked to hospital infections across the world. Some of their representatives demonstrate high resistance to commonly-used... Read more


view channel
Image: Flexible copper sensor made cheaply from ordinary materials (Photo courtesy of University of São Paulo)

Low-Cost Portable Sensor Detects Heavy Metals in Sweat

Heavy metals like lead and cadmium can be found in batteries, cosmetics, food and many other things that have become a part of daily life. However, they become toxic if they accumulate in the human body... Read more
Copyright © 2000-2023 Globetech Media. All rights reserved.