Urinary and Tissue Immunohistochemical Expression of Complement Activation Products among Diabetic Nephropathy Patients in Different Stages

Document Type : Original Article

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Abstract

Background: It is currently unclear what role of urinary complement activation products (CAPs) play among diabetic nephropathy (DN) patients. Objective: To assess complement activation products (C5a) contribution to diabetic nephropathy development in urine and tissue. Patients and methods: A cross-sectional study was conducted at the Nephrology Unit and Pathology Department of Zagazig University Hospitals. This study included sixty-two diabetic patients who had diabetic nephropathy. Urinary C5a levels by ELISA and tissue immunohistochemical expression of C5 a receptor (C5aR) were assessed among all patients. Results: Statistically significant difference was found regarding C5a level and its tissue receptors which was higher among the grade IV group and lower among the grade IIa group. Age, HDL, and albumin/ creatinine ratio showed statistically significant correlations with C5a and its receptors. Diabetic duration, nephropathy classes, and C5a, C5aR showed statistically significant correlations with albumin/ creatinine ratio. Age, diabetic duration, HDL, fasting blood glucose level, albumin creatinine ratio, and C5a showed statistical significance as predictors for diabetic nephropathy grades III or IV. At a cutoff value equal to 74.4, C5a had 80.8% sensitivity and 66.7% specificity in the prediction of diabetic nephropathy grade III and IV.
Conclusion: Since urinary and tissue CAPs and the severity of DN are closely correlated, doctors may utilize them as markers to assess the disease's severity and development, particularly in cases when renal tubules are injured.
 

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The Egyptian Journal of Hospital Medicine
Volume 89, Issue 2
October 2022
Pages 7009-7018

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