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Plasma Cyclophilin-A as a Novel Biomarker in Chronic Nephropathy

Mohy Eldin Abd EL-Fattah

Background: Type 2 diabetes mellitus (DM) is the most common cause of end- stage renal disease. Albuminuria is the foremost commonly utilized marker to anticipate onset of diabetic nephropathy (DN) without sufficient affectability and specificity to identify early DN.

Aim: This study aimed to evaluate plasma Plasma cyclophilin A (CypA) as a new biomarker for early DN.

Methods: This cross sectional study included 125 Egyptian subjects attending the out Patients Clinic of the Department of Internal Medicine, 10Th of Ramadan city Health Insurance Hospital and divided into:-control group, patient with diabetic mellitus, patients with Diabetic nephropathy and patient with diabetic nephropathy and other complications. Patients were subjected to measurement of plasma α- Klotho, FBS, HbAIC, serum Creatinine, serum urea, serum uric acid, k, Na, serum phosphorus, Albumin: Creatinine Ratio, GFR, Chol, TG, LDL HDL, AST, ALT, T.BIL, D.BIL ALB, TP, GLB and A/G ratio.

Results: Results showed that plasma a-klotho was significantly correlated with haemoglobin A1C, potassium, GFR, Albumin, TP and GLB. Meanwhile, plasma a- klotho was negatively correlated with duration of DM, CR, Urea, UR.A, Na, phosphorus, ACR, Chol, TG, LDL, AST, ALT, T.BIL, and D.BIL. However, there were no significant correlations between plasma a-klotho and FBS, HDL and A/G ratio. At cut-off level ≥84.14, cyclophilin A had 91% sensitivity and 62% specificity for diagnosing diabetic nephropathy.

Conclusion: CypA can be used as an early marker for DN as we found early significant high levels of urinary CypA in diabetic patients with stage 2 DN even before the appearance of albuminuria.