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Background: Diabetes mellitus has been described as a metabolic disorder of multiple etiology characterized by chronic hyperglycemia with disturbances of carbohydrate metabolism. Diabetic nephropathy is typically characterized by a gradual increase in urinary albumin excretion. Albuminuria, a marker of glomerular involvement in early renal damage, cannot always detect early diabetic nephropathy (DN). Aim of the Work: Is to determine the suggested promising diagnostic role of kidney injury molecule-1 (KIM-1) level and β2 microglobulin and how could improve the early diagnosis, predict disease progression and deliver new insights in pathogenic of diabetic nephropathy. Subjects and Methods: this study included 80 subjects. Group I: sixty (60) patients with T2DM classified into 3 subgroups according to the level of albumin/creatinine ratio (ACR). Thirty (30) diabetic patients with normoalbuminuria (1a), 20 diabetic patients with microalbuminuria (1b) and 10 diabetic patient with macroalbuminuria (1c). Group II: Twenty, age and sex matched, apparently healthy individuals serving as a control group. Results: Our results revealed a statistical significant increase in FBS, blood urea, as well as microalbuminuria with GFR decline in patients group when compared to control group. However, serum levels of creatinine were only significantly elevated in diabetic patients with ACR ≥300 mg/g when compared to control group. The results revealed a highly statistically significant increase in urinary KIM and β2 microglobulin levels in micro than normo and in macro than micro albuminuric group. Conclusion: Our data revealed that tubular biomarkers were increased in T2DM patients with normoalbuminuria when compared with controls.

Role of Kidney Injury Molecule-1 and 2-Microglobulin in Early Diagnosis of Diabetic Nephropathy