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International Urology and Nephrology
Published in: International Urology and Nephrology 5/2024

29-10-2023 | Microalbuminuria | Nephrology - Review

Evaluation of N-acetyl-β-D-glucosaminidase as a prognostic marker for diabetic nephropathy in type 2 diabetics: systematic review and meta-analysis

Authors: Augusto dos Santos Bitencourt, Régis Leães Vargas Filho, Gabriele da Silveira Prestes, Maria Laura Rodrigues Uggioni, Fernanda Marçal, Tamy Colonetti, Maria Inês da Rosa

Published in: International Urology and Nephrology | Issue 5/2024

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Abstract

Objective

This review aimed to assess the utility of urinary N-acetyl-β-D-glucosaminidase (uNAG) as a prognostic biomarker for nephropathy in patients with type 2 diabetes mellitus.

Methods

The search for relevant studies was conducted across multiple databases, including PubMed (Medline), EMBASE, LILACS, CENTRAL, IBECS, and gray literature. We employed a random effects model to calculate the standardized mean difference and 95% confidence interval. Furthermore, we assessed heterogeneity using Cochrane's Q test and Higgins' I2 statistics.

Results

This review included a total of 16 articles involving 1669 patients, with 13 being case–control studies and three being cohorts. The meta-analysis conducted across all studies revealed significant heterogeneity. However, subgroup analysis of four studies indicated that an increase in uNAG among normoalbuminuric patients was associated with the development of macroalbuminuria (DMP = – 1.47; 95% CI = – 1.98 to 0.95; p < 0.00001; I2 = 45%). Conversely, it did not demonstrate effectiveness in predicting the development of microalbuminuria (DMP = 0.26; 95% CI = – 0.08 to 0.60; p = 0.13; I2 = 17%).

Conclusions

Elevated uNAG levels in normoalbuminuric patients may indicate an increased risk for the development of macroalbuminuria, but not microalbuminuria. However, the high heterogeneity observed among the studies highlights the necessity for further research to validate these findings.
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Metadata
Title
Evaluation of N-acetyl-β-D-glucosaminidase as a prognostic marker for diabetic nephropathy in type 2 diabetics: systematic review and meta-analysis
Authors
Augusto dos Santos Bitencourt
Régis Leães Vargas Filho
Gabriele da Silveira Prestes
Maria Laura Rodrigues Uggioni
Fernanda Marçal
Tamy Colonetti
Maria Inês da Rosa
Publication date
29-10-2023
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 5/2024
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-023-03843-3

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