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Year : 2019  |  Volume : 17  |  Issue : 3  |  Page : 259-263

Urinary heme oxygenase-1 as a new and early marker of diabetic nephropathy

Department of Clinical Pathology, Faculty of Medicine, Assuit University, Assuit, Egypt

Correspondence Address:
Zeinab A Abd El-Hameed
Lecture of Clinical Pathology, Department of Clinical Pathology, Faculty of Medicine, Assuit University, Assuit
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/AZMJ.AZMJ_56_19

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Introduction Microalbuminuria is considered an early marker of glomerular injury in patients with diabetes, but tubular injury can precede glomerular injury and cannot be detected by microalbumin. We need a new and early marker of kidney injury in normoalbuminuric diabetic patients. Urinary heme oxygenase-1 (uHO-1) is an enzyme that is produced in tubules in response to oxidative stress and can be a marker of tubular injury. Aim To investigate the clinical implication of uHO-1 as an early diagnostic marker in diabetic nephropathy (DN). Patients and methods A total of 65 diabetic patients, comprising 20 microalbuminuric patients and 45 normoalbuminuric patients, and 20 healthy participants as a control group were included in this study. Level of uHO-1 was detected by enzyme-linked immunosorbent assay. Results uHO-1 was highly significantly elevated (P<0.000) in microalbuminuric group compared with normoalbuminuric group and control group, respectively. Normoalbuminuric group was highly significantly elevated (P<0.000) in uHO-1 compared with the control group. uHO-1 was positively correlated with albumin–creatinine ratio but was not correlated with estimated glomerular filtration rate. Receiver operating characteristic curve analysis of uHO-1 levels for early diagnosis of DN revealed that the cutoff value of uHO-1 was 5.8 ng/ml (sensitivity 80% and specificity 71%) for early diagnosis of DN. Conclusion The findings of this study indicate that elevated levels of uHO-1 can be detected in normoalbuminuric diabetic patients and revealed renal tubular damage. uHO-1 may be used as an early biomarker for DN.

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