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The soluble serum transferin receptors in type 2 diabetic patients with proteinuria

To record the difference in the level of soluble serum transferrine receptors (sTfr) in type 2 diabetic patients with selective nephrotic proteinuria (SNP) compared to patients with nonselective nephrotic proteinuria (NNP), and confirm the thesis that the sTfr is good marker of iron status and erythropoesis in these patients. Methods. There were 63 type 2 diabetic patients with diabetic nephropathy and proteinuria included in the study. The patients were divided in to 3 groups regarding largeness and selectivity of proteinuria. Twenty-four patients had SNP, and ninteen patient had NNP. Control group constitute twenty patients with selective non-nephrotic proteinuria <2.5 g/day. In all groups were measured: erythrocyte count, hemoglobin level, mean cell volume, C reactive protein, fibrinogen level, serum iron level, total iron binding capacity, unbound iron binding capacity, iron saturation, serum ferritin, cratinine clearance, serum protein electrophoresis, proteinuria (biuret), urinary protein immunoelectrophoresis, and sTfr. The sTfr were detected in serum using ELISA techniques, and quantified in mg/L. Results. We recorded significant difference in sTfr level between NNP group and SNP group, and between NNP group and control group (NNP 2.0+/-0.8 ; SNP 2.9+/-1.8 ; control 2.7+/-1.0 ; p<0.05 ; p<0.05), and significant difference in biuret and fibrinogen level between NNP and SNP group in compare to control group (p<0.05 ; p<0.05). Conclusion. Significantly lower sTfr in NNP group in compare to SNP and controle group, and in absence of significant difference in both iron and erythropoesis markers and factors with possible negative contribution according to both of them (e.g. inflammation, stage of renal insufficiency), is probably result of loss of sTfr through heavily and largely damaged glomerular capillary membrane in NNP group. Therefore, sTfr is not good marker of iron status and erythropoesis in type 2 diabetic patients with NNP.

type 2 diabetic patient; nephrotic proteinuria; serum soluble transferrine receptors; erythropoesis

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