Background: Altered kidney structure and function is the most important evidence of diabetic nephropathy (DN), also
known as diabetic kidney disease (DKD), and is an important cause of permanent renal impairment. Urinary albumin/creatinine
proportion and glomerular filtration rate are utilised in ordinary work practise in the Republic of Iraq to detect DKD. These routine
tests, on the other hand, do not always detect initial DN damage. In the current study, early kidney damage is detected by urine
biomarker NGAL and Cystatin C, even if the patients do not show any symptoms. Research design and methods :This study used
a cross-sectional design all 180 participant are female with type 2 diabetes mellitus the ages of 40 and 70. Were enrolled during
the period between June 2021 to February in 2022. Those patients were attended to Diabetic center for admitted in the Teaching
Hospitals of Wasit Governorate (Iraq). After taking informed consent from each. We chose n=67 NDKD and n=113 DKD (eGFR
60 mL/min/1.73 m2
and uACR >30 mg/g) from the participants who were separated into two groups based on the ratio of eGFR to
uACR. Results: The DKD group had significantly higher concentration of of NGAL and Cystatin C in urine than the NDKD group,
according to the study's findings. In both groups with diabetes, receiver operating characteristic (ROC) curves where uNCR was
known to be greater than uNCR for estimating eGFR/uACR were found to be better than uNCR for estimating eGFR/uACR, which
gave the uNCR: AUC 0.973, (95%CI): (0.921, 1.000), Specificity 97%, Sensitivity 90 %, PPV 98%, NPV 93% with accuracy 93%
and precision 98%, (log-rank test P=0.005). Conclusions: Urine markers such as NGAL and Cystatin C It may serve as a possible
technique for detecting cases with a significant clinical suspicion of DKD, particularly if it is attributable to uACR.
Key words: Type 2 Diabetic Mellitus, Diabetic Kidney Disease, NGAL Cystatin C
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