Diagnostic value of renal function related urine indicators in early diabetic nephropathy

Xian Yingyi; Ye Jinhua; Shuai Hu; Liu Jian

doi:10.3969/j.issn.1674-7151.2025.03.007

Abstract：Objective To investigate the diagnostic value of urinary retinol binding protein(RBP),microalbumin(MA),creatinine(Cr)and microalbumin to creatinine ratio(MA/Cr)in early diabetic nephropathy.Methods Fifty patients with early diabetic nephropathy admitted to the First People's Hospital of Zhaoqing City from February 2022 to February 2024 were selected as research subjects and included in observation group.In addition,50 patients with simple diabetes mellitus during the same period were selected as control group.After admission,the levels of urine RBP,MA and Cr in all patients were detected using automatic specific protein analyzer,MA/Cr was calculated,and the differences of above indicators between two groups were compared.The receiver operator characteristic curve(ROC curve)was drawn to evaluate the diagnostic value of RBP,MA,Cr,MA/Cr alone and in combination for early diabetic nephropathy.Results The levels of MA and MA/Cr in observation group were significantly higher than those in control group[MA(mg/L):376.42±79.39 vs.10.95±2.20;MA/Cr(g/mol):79.55±19.38 vs.1.58±0.30;both P<0.05],while no significant differences were observed in RBP or Cr levels between two groups[RBP(mg/L):3.97±0.96 vs.2.51±0.96;Cr(mmol/L):8.41±0.94 vs.7.88±0.78;both P>0.05].The area under ROC curve(AUC)of combined detection of urine RBP,MA,Cr and MA/Cr in diagnosis of early diabetic nephropathy was 0.960,and the sensitivity and specificity were 90.00%and 98.00%,respectively.The diagnostic value of combined detection was better than those of RBP and Cr alone.Conclusions The levels of urine MA and MA/Cr in patients with early diabetic nephropathy were significantly higher than those in patients with simple diabetes mellitus,but the levels of RBP and Cr do not change significantly.The combined detection of urine RBP,MA,Cr and MA/Cr has high specificity in the diagnosis of early diabetic nephropathy,but has little overall advantage compared with detection of MA and MA/Cr alone.