CHANGES IN CERTAIN BIOCHEMICAL AND IMMUNOLOGICAL PARAMETERS IN CHRONIC KIDNEY DISEASE IN PATIENTS WITH DIABETES MELLITUS

Lyatifova N. F.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Goal. Studying the level of certain cytokines in the blood serum of type II patients and evaluating their diagnostic value in the development of DNA, depending on the degree of clinical severity of the disease. Object and methods. The study was transferred to the Clinical and biochemical laboratory of the Azerbaijan Medical University, where blood samples of 78 patients aged 36 to 75 years were examined. All patients were divided into 3 groups: group I – 28 patients with unexplained CSF, group II – 21 patients with MD, and the third group – 28 patients with SD. The control group consisted of 14 Saglam practitioners. The level of glycosylation in patients with DM was determined based on the amount of glycosylated hemoglobin in the blood. To assess kidney function, serum creatinine, urine content, cystatin C, and FABP were analyzed. The presence of creatine and sesquiter was determined kinetically using a set of reagents belonging to the Diagnosticum. The determination of vitamin C and FABP was performed using enzyme immunoassay using the Cloud Clon jet set. The participation of IL-6, 8, 10, and TNF-Il was determined by enzyme immunoassay (ELISA) based on the sandwich principle with a set of immunoassays belonging to the Best vector. Results. In all three groups of patients with diabetes, glucose and glycohemoglobin levels are below normal. The incidence of glucose and HbA1c in patients with DN was 19.1% and 23.3% (p <0.025) compared to group I, 31.1% and 45.2% (p <0.001) in the blood of patients with diabetic origin, respectively. As a rule, the creatinine content in blood plasma is the most frequently used marker in the study of renal function. Creatine enters the bloodstream at a constant rate from muscle tissue and depends on muscle mass, gender, and age. It does not combine with plasma proteins and is filtered out of the kidney bladder with a small amount of secretions in the urine. An increase in plasma creatinine levels can lead to an increase in duct secretion, which leads to an erroneous calculation of the spill filtration rate according to the Rehberg test. Cystatin C, in contrast to creatinine, is considered a more specific and accurate diagnostic criterion for evaluating secretory kidney functions. Cystatin C is synthesized in various cells of the body, the blood flows at a constant rate, is freely filtered from the kidneys and promotes full metabolism in the proximal ducts. Its presence is highly dependent on age, gender, and muscle mass, which allows early detection of renal dysfunction compared to creatinine. The clinical sensitivity of cystatin C is 86%, and the specificity is 82%. The results show that the incidence of cystatin C is 21.6% higher in the serum of patients with DN compared to group I and 1.9 times higher (p <0.001) in patients with diabetes mellitus. Thus, the co-determination of creatinine and cystatin C in patients with type II diabetes may play an important role in the early diagnosis of kidney damage. The diagnosis of L-FABP in combination with creatinine and cystatin C has been used to diagnose DNA and P in diabetic patients. During acute kidney injury, the concentration of L-FABP in the blood increases within 24 hours, indicating that it is a sensitive marker. Conclusions. The results show that the study of cytokines, along with biochemical indicators that reflect kidney function in patients with diabetes, can play an important role in the early detection of CPN in these patients and in the application of new therapeutic methods.

chronic kidney disease, diabetes mellitus, creatinine, cystatin C.

1. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103:137-49.
2. Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001;414:782-7.
3. Andreeva AS, Hamnuyeva AY, Shagun OV. Role of cytokines in pathogenesis of diabetes mellitus. Siberian medical journal. (Irkutsk). 2005;1:5-7.
4. Liu Y. Cellular and molecular mechanisms of renal fibrosis. Nature Reviews. Nephrology. 2011;7(12):684-96.
5. Bgatova II, Bondar IA, Klimontov VV, Nadeev AI. Initial changes in the udder of the baby diarrhea with type 1. Prob. Endocrine. 2017;5:3-8.
6. Baturina TV, Sergeev TV. Cytokines and adherent molecules in pathogenesis of chronic glomerulonephritis. Nephrology and dialysis. 2012;4(4):33-239.
7. Donate-Correa J, Martín-Núñez E, Muros-de-Fuentes M, Carmen Mora-Fernández C, Navarro-González JF. Inflammatory Cytokines in Diabetic Nephropathy. J Diabetes Res. 2015;2015:948417.
8. Uzaeva LI, Maksudova AN. Biomarker rannego povrezhdenija pochek: obzor literatury. Prakticheskaja medicina. 2014;1(4):125-30. [in Russian].
9. Reinhard M, Erlandsen EJ, Randers E. Biological variation of cystatin C and creatinine. Scand J Clin Lab Invest. 2009;69(8):831-6.

«Bulletin of problems biology and medicine» Issue 1 (155), 2020 year, 148-151 pages, index UDK 616.61-036.12-02

10.29254/2077-4214-2020-1-155-148-151