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J Nephropathol. 2020;9(4): e39.
doi: 10.34172/jnp.2020.39

Scopus ID: 85085314372
  Abstract View: 318
  PDF Download: 127

Original Article

The relationship between urinary and plasma levels of tumor necrosis factor alpha and various stages of chronic kidney disease in patients with type II diabetes mellitus

Alireza Soleimani 1, Maryam Soleimani 2, Forouz Farzadnejad 2 * ORCID logo, Mohammadreza Tamadon 3 ORCID logo

1 Department of Internal Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
2 Pharmacy Student in Ankara University
3 Department of Internal Medicine, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
*Corresponding author: Forouz Farzadnejad; Email: foryfa@gmail.com

Abstract

Introduction: The concept of diabetic nephropathy, as a metabolic disease, is now being replaced by chronic low-grade inflammatory disease. Tumor necrosis factor alpha (TNF-α) is a proinflammatory cytokine that plays an important role in the pathogenesis and clinical outcomes of diabetic nephropathy.

Objectives: This study aimed to determine the relationship between plasma and urinary levels of TNF-α and chronic kidney disease (CKD) in patients with type 2 diabetes mellitus.

Patients and Methods: In this descriptive-analytical study, patients with type 2 diabetes mellitus who referred to the endocrine clinic in Kashan (2016) were enrolled in the study and their clinical and laboratory data were recorded. Albumin/creatinine ratio (ACR) and glomerular filtration rate (GFR) were calculated. The patients were divided into three groups based on their GFR. Serum and urinary levels of TNF-α were determined by ELISA and were compared between the studied groups.

Results: A total of 128 patients were evaluated. Of all, 35 patients (27.3%), 39 patients (30.4%), and 54 patients (42.3%), respectively, were suffering from stage 1, stage 2, and stage 3 CKD. The plasma levels of TNF-α in patients with stage 1, 2, and 3 CKD, were 66.20 ± 33.27 pg/mL, 67.47 ± 42.98 pg/mL, and 77.32 ± 47.23 pg/mL respectively, since the difference among them was not significant (P= 0.417). In addition, the urinary levels of TNF-α in patients with stage 1, 2, and 3 CKD, respectively, were 88.18 ± 26.66 pg/mL, 97.41 ± 57.76 pg/mL, and 101.18 ± 60.47 pg/mL, since no significant difference was observed between the three groups (P=0.957).

Conclusion: Based on the results of this study, with changing the stage of CKD, the serum and urinary levels of the TNF-α increases too, although this increase is not significant. Moreover, the plasma and urinary levels of the TNF-α have a direct and significant relationship with each other. It is recommended to conduct further studies in this field.

Keywords: Type II diabetes mellitus, Chronic kidney disease, Diabetic nephropathy, Tumor necrosis factor, End-stage renal disease, Angiotensin aldosterone system

Implication for health policy/practice/research/medical education:

To determine the relationship between plasma and urinary levels of TNF-α and different stages of CKD in patients with type 2 diabetes mellitus, we conducted a descriptive analytical study on 128 patients. The results showed that plasma and urinary levels of TNF-α had no significant relationship with the stages of CKD. Based on the results of this study, with changing the stage of CKD, the serum and urinary levels of the TNF-α increase as well, although this increase is not significant. Moreover, the plasma and urinary levels of the TNF-α have a direct and significant relationship with each other.

Please cite this paper as: Soleimani A, Soleimani M, Farzadnejad F, Tamadon MR. The relationship between urinary and plasma levels of tumor necrosis factor alpha and various stages of chronic kidney disease in patients with type II diabetes mellitus. J Nephropathol. 2020;9(4):e39. DOI: 10.34172/jnp.2020.39.

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Submitted: 21 Sep 2019
Accepted: 30 Oct 2019
ePublished: 15 May 2020
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