Assessment of NGAL, KIM-1 and ADMA in chronic kidney disease patients in Wasit province, Iraq

Abstract

The study highlights the importance of new biomarkers (NGAL, KIM-1 and ADMA) in predicting early onset and progression of chronic kidney disease. Using these markers alongside traditional measures like eGFR and serum creatinine provides a comprehensive understanding of chronic kidney disease severity, leading to improved diagnosis, treatment, and patient outcomes. This can enhance health policy, clinical practices, and medical education.

Introduction:

 Kidney disease encompasses conditions that lead to functional or structural disorders of the kidney. It is characterized by a glomerular filtration rate (GFR) below 60 mL/min/m² for over three months or blood urea concentrations exceeding 80 µmol/L. More than 50% of cases result in lethality, with only a third of patients surviving longer than three months. Chronic kidney disease (CKD) and impaired renal function vary in severity but share common issues, such as proteinuria (≥100 mg albuminuria for over 90 days and a GFR< 60 mL/min/1.73 m²). Early identification, timely treatment, and monitoring can prevent disease progression.

Methods: The current clinical study aimed to evaluate the severity of CKD in 60 patients aged 18 to 85 years and compare them with 30 healthy controls, focusing on CKD stages 3 to 5.We utilized the estimated GFR (eGFR) to identify CKD, with stage 5 representing kidney failure occurring within three months. Serum creatinine was used as a crucial marker due to its free filtration and non-metabolization by renal tubules. New biomarkers, including, neutrophil gelatinase-associated lipocalin (NGAL), asymmetric dimethyl arginine (ADMA(, and kidney injury molecule-1 (KIM-1) were evaluated for their ability to predict early kidney disease onset and indicate inflammation. Data were collected through questionnaires from all participants, excluding those with cancer, viral hepatitis, or hormonal disorders.

 Results: Our study established correlations between new biomarkers, disease severity, and eGFR. Statistically significant differences across disease stages were identified using the CKD-EPI formula, which considers creatinine level, age, gender, and race.

Conclusion: The study highlights the importance of new biomarkers in predicting early onset and progression of CKD. Monitoring these markers alongside traditional measures like eGFR and serum creatinine can provide a comprehensive understanding of disease severity and improve patient outcomes.