Evaluation of Urinary Excretion of Transferrin as a Marker for Early Diabetic Nephropathy

Microalbuminuria has been accepted as a gold standard for the indicator of incipient nephropathy in persons with diabetes mellitus. The purpose of this study was to determine whether microtransferrinuria can be used as an additional marker for early diabetic nephropathy. We measured transferrin, albumin and creatinine concentrations in the first morning urine specimen from 903 persons with non-insulin dependent diabetes mellitus whose serum creatinine concentration was below 2.0 mg/dl. There were significant differences among the geometric mean urine transferrin/creatinine ratios (TCRs) of normo-, micro- and macroalbuminuric diabetic subjects (0.31, 2.15 and 43.06 mg/gCr, respectively). Although urine TCR strongly correlated with urine albumin/creatinine ratio (ACR, r_s=0.9354, p