LAUSR

Background Diabetic nephropathy (DN) is the foremost cause of chronic kidney disease (CKD), which may lead to end-stage renal disease. Due to the inconsistent modifications in urine albumin, the conventional immunoassays underestimate urine albumin, thereby delaying the diagnosis. This study was designed to find an alternative urinary marker for the early detection of DN. Methods Urine neutrophil gelatinase-associated lipocalin (NGAL) was estimated along with routine tests. This cross-sectional study recruited 180 healthy controls (group I), 103 diabetics without microalbuminuria (group II), and 102 diabetics with microalbuminuria (group III). Results There was an increasing trend for urinary NGAL from group I to III in both the females and males ( p  = 0.003, 0.004, respectively).With the urine NGAL cut-off of 70.87 ng/ml, there was 66.7% sensitivity and 66.8% specificity, and the odds of diabetic patients having nephropathy was 4.02. Combining the urine albumin creatinine ratio (UACR) and U NGAL, the AUC improved to 1.000 ( p  = 0.000) for UACR and U NGAL had AUC of 0.992 ( p  = 0.004). Conclusion As tubular damage occurs prior to glomerular damage in DN, we conclude that measurement of urinary NGAL predicts DN better than microalbumin alone.