Pattern of proteinuria in Type 1 Diabetes- Version 1 (02/04/2013)
Research type
Research Study
Full title
The excretion pattern of albumin and low molecular weight proteins in Type 1 Diabetes: a pilot study
IRAS ID
116006
Contact name
Supriya Joshi
Contact email
Sponsor organisation
East and North Herts NHS Trust
Research summary
Excretion of toxic and waste products whilst retaining necessary nutrients is an important function of the kidney. Small compounds are freely filtered through fine pores within tufts of capillaries (small blood vessels) called glomeruli (singular- glomerulus). They are then reabsorbed as necessary within the tubules of the kidney. Albumin is a relatively large protein which is not usually found in the urine of normal people. The presence of albumin in urine (albuminuria) has traditionally been attributed to glomerular damage. Curiously, however, patients with known tubular disorders are also known to excrete albumin in urine in addition to some low molecular weight proteins such as retinol binding protein (RBP), beta-2 microglobulin (B2M) and vitamin d binding protein (VDBP). Indeed, the excretion of RBP and albumin follows a signature pattern in patients with tubular disorders. Notably, albuminuria is also seen in patients with Type 1 Diabetes (T1DM) and is used as a marker of kidney damage (diabetic nephropathy). The amount of albumin excreted is expressed in terms of albumin creatinine ratio (ACR). Microalbuminuria is the term used to denote an ACR of less than 30 mg/mmol , while macroalbuminuria denotes an ACR of greater than 30 mg/mmol.
Several studies have demonstrated the presence of RBP, VDBP and B2M in the urine of patients with Type 1 DM both with and without albuminuria. However, the pattern of excretion of these compounds in patients with T1DM has not been studied previously.This project aims to examine the pattern of protein excretion in T1DM by looking at the ratio of albumin to RBP in patients with and without microalbuminuria. Other low molecular weight proteins namely, vitamin D binding protein, beta-2 glycoprotein and freelight chains may also be measured in order to examine the excretion pattern of these low molecular weight proteins.REC name
London - Harrow Research Ethics Committee
REC reference
13/LO/0796
Date of REC Opinion
23 Jul 2013
REC opinion
Further Information Favourable Opinion