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Nephrol Dial Transplant (1994) 9: 377-381
© 1994 European Renal Association-European Dialysis and Transplant Association

research-article

Human urinary intestinal alkaline phosphatase as an indicator of S3-segment-specffic alterations in incipient diabetic nephropathy

G. D. Nuyts1, M. Yaqoob2, E. J. Nouwen1, A. W. Patrick2, P. McClelland2, M. E. De Broe1,, I. A. MacFarlane3 and G. M. Bell2

1University Hospital Antwerp Antwerp, Belgium 2Royal Liverpool University Hospital Liverpool 3Walton General Hospital Liverpool, UK

Correspondence and offprint requests to: Correspondence and offprint requests to: Marc E. Dc Broe MD, PhD, Head of Department Nephrology-Hypertension, University of Antwerp, p/a University Hospital Antwerp Wilrijkstraat 10 B-2650 Edegem-Antwerp Belgium

Urinary enzymes were determined in a controlled study including 28 type I diabetes mellitus patients. Fifteen patients had persistent microalbuminuria and were compared to 13 normoalbuminuric patients with comparable age and sex distribution. All patients had normal renal function as measured by serum creatinine. Human intestinal alkaline phosphatase (hIAP), a specific marker of the proximal tubular S3 segment, was elevated in the urine of microalbuminuric patients while human tissue non-specific alkaline phosphatase (hTNAP), indicating effects mainly at the S1-S2 segments, was not. Urinary hIAP was correlated with serum glycated haemoglobin. These results suggest that tubular alterations are present at an early stage of diabetic nephropathy, especially at the S3 segment, and that hIAP may have promise as an early marker.

Keywords: diabetic nephropathy; early markers; intestinal alkaline phosphatase; S3 segment; urinary enzyme


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