Osama F Mosa, Mahmoud Rizk, Asmaa M Ahmed


Background: Diabetic kidney disease (DKD) is a time progressive problem, give rise in uncontrolled Diabetics increasing risks for chronic kidney disease (CKD) and /or end-stage renal disease (ESRD). The vulnerability to renal dysfunction manifested with sudden glomerular hypofiltration associated with micro-to macroalbuminuria passing to renal failure. So that, screening of specific enzymes shifts, or urinary albumin may predict onset diabetic nephropathy. Objective:The assessment of urinary alkaline phosphatase (ALP), alanine aminopeptidase (AAP), acid phosphatase (ACP) and microalbuminuria (MAU) for type II diabetic patients. Patients and Methods: In this study,120 type II diabetic patients were compared to 90 healthy volunteers of matched age and sex in Al-Leith General Hospital, Al-Leith Kidney Unit (AKU), Al-Leith, Makkah area, KSA in which random urine samples were collected for testing of MAU, ALP, AAP, ACP and Cr. Results: Mean values of measured biomarkers in patient group for MAU, ALP, AAP, ACP and Cr were 51.92 mg/I, 41.55 U/L, 20.17 U/L, 570.10 U/L and 2.92 mg/dl VS in control group were 12.59 mg/I, 8.84 U/L, 6.94 U/L, 385.87U/L and 1.07 mg/dl respectively. Additionally, there were statistically positive correlation between AAP with MAU and ALP; ACP with MAU, ALP and AAP; Cr level with MAU, ALP, AAP and ACP; on the other hand, there were positive significant correlation between duration of diabetes with all studied markers. Conclusion: Using of MAU in addition to other urinary enzymes could be beneficial non-invasive indicators for renal deterioration in type II diabetics.


Alkaline phosphatase, Alanine aminopeptidase, Acid phosphatase, Microalbuminuria, Diabetic kidney disease, Diabetes mellitus type II

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Al-Lawati JA. Diabetes mellitus: a local and global public health emergency. Oman Med J. 2017; 32(3): 177–9.

Hameed I, Masoodi S, Mir S, Nabi M, Ghazanfar K, Ganai B. Type 2 diabetes mellitus: From a metabolic disorder to an inflammatory condition. World J Diabetes. 2015; 6(4): 598-612.

Wu Y, Ding Y, Tanaka Y, Zhang W. Risk factors contributing to Type 2 Diabetes and recent advances in the treatment and prevention. Int J Med Sci. 2014; 11(11):1185-200.

Malecki MT. Type-2 Diabetes mellitus and its complications: from the molecular biology to the clinical practice. Rev Diabet Stud. 2004; 1(1):5-8.

Sutherland C, Campbell DG, Cohen P. Identification of insulin-stimulated protein kinase-1 as the rabbit equivalent of rskmo-2. Identification of two threonines phosphorylated during activation by mitogen-activated protein kinase. Eur J Biochem. 1993; 212(2): 581-8.

Trevisan R, Vedovato M, Tiengo A. The epidemiology of diabetes mellitus. Nephrol Dial Transplant. 1998; 13(suppl 8): 2–5.

Murea M, Ma L, Freedman BI. Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications Rev Diabet Stud. 2012; 9(1): 6–22.

Afkarian M, Zelnick LR, Hall YN, Heagerty PJ, Tuttle K, Weiss NS, et al. Clinical manifestations of kidney disease among US adults with diabetes, 1988-2014. JAMA. 2016; 316(6):602-10.

Borch-Johnsen K. The prognosis of insulin-dependent diabetes mellitus. An epidemiological approach. Dan Med Bull. 1989; 36(4):336–48.

de Boer IH, Gao X, Cleary PA, Bebu I, Lachin JM, Molitch ME, et al. Albuminuria changes and cardiovascular and renal outcomes in type 1 diabetes: The DCCT/EDIC Study. Clin J Am Soc Nephrol. 2016; 11(11):1969–77.

Persson F,Rossing P. Diagnosis of diabetic kidney disease: state of the art and future perspective. Kidney International Supplements. 2018;8(1): 2–7.

Poudel B, Yadav BK, Nepal AK, Jha B, Raut KB. Prevalence and association of microalbuminuria in essential hypertensive patients. N Am J Med Sci. 2012; 4(8):331-5.

Futrakul N, Sridama V, Futrakul P. Microalbuminuria: a biomarker of renal microvascular disease. Ren Fail. 2009;31(2):140-3.

Al-Houli NH. Leptin and Soluble Leptin Receptor (OB-Re). Among Obese Patients in Gaza Strip. A dissertation submitted as part of requirement for the degree of Masters of Biological Sciences in Medical. Technology in IUG. 2006.

Go AS, Chertow GM, Fan D, Mc Culloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004; 351(13):1296–305.

Bloomgarden ZT. Diabetic nephropathy. Diabetes Care. 2008; 31(4):823–7.

Anavekar NS, Gans DJ, Berl T, Rhode RD, Cooper W, Bhaumik A, et al.Predictors of cardiovascular events in patients with type 2 diabetic nephropathy and hypertension: a case for albuminuria Kidney Int Suppl. 2004;92: S50-5.

Park HY, Schumock GT, Pickard AS, Akhras K. A structured review of the relationship between microalbuminuria and cardiovascular events in patients with diabetes mellitus and hypertension. Pharmacotherapy. 2003;23(12):1611–16.

Salvadori M, Tsalouchos A. Biomarkers in renal transplantation: An updated review. World J Transplant. 2017;7(3):161-78.

Uslu S, Efe B, Alatas O, Kebapçi N, Colak O, Demirüstü D, et al. Serum cystatin C and urinary enzymes as screening markers of renal dysfunction in diabetic patients. J Nephrol. 2005; 18(5): 559-67.

Lary SA. Urinary enzymes and microalbuminuria as indicators of renal involvement in patients with diabetes mellitus in Saudi Arabia. Saudi J Kidney Dis Transpl. 2004; 15(1):18-26.

Currie G, McKay G, Delles C. Biomarkers in diabetic nephropathy: Present and future. World J Diabetes. 2014; 5(6): 763–76.

Lee MK, Han KD, Lee JH, Sohn SY, Hong OK, Jeong JS, et al. Normal-to-mildly increased albuminuria predicts the risk for diabetic retinopathy in patients with type 2 diabetes. Scientific Reports. 2017; 7(1):11757.

DOI: http://dx.doi.org/10.24125/sanamed.v13i2.254


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