Kidney Injury Molecule-1, Cystatin c and Microalbuminuria Levels among Diabetics Compared to Healthy Adults Attending Rivers State University Teaching Hospital, Port Harcourt, Nigeria: A Comparative Analytic Cross Sectional Study

Abstract

Background: Diabetes mellitus affects over 422 million people globally, with projections estimating 643 million cases by 2030. Diabetic nephropathy remains one of its most common complications, underscoring the need for early detection. Aim: To assess the levels of Kidney injury Molecule-1 (KIM-1), cystatin C, and microalbuminuria among diabetic patients at Rivers State University Teaching Hospital (RSUTH). Methodology: A comparative analytical cross-sectional study was carried out in Rivers State University Teaching Hospital (RSUTH) from September 2024 to December 2024. A total of 140 participants were recruited—70 diabetic patients and 70 age- and sex-matched healthy controls residing in Port Harcourt. Demographic and clinical data were collected using questionnaires. Laboratory analyses included HbA1c, KIM-1, cystatin C, fasting blood glucose, urea, creatinine, sodium, chloride, potassium, bicarbonate, and microalbuminuria were conducted. Data were analyzed using GraphPad Prism v9.0.0, with significance set at P<0.05. Results: KIM-1 levels were significantly higher in the test 23.97 ± 18.94 pg/mL compared with control group 6.678 ± 5.347 pg/mL, (P<0.0001). Cystatin-C levels were significantly higher in test 18.54 ± 7.441 ng/mL in comparison with the control group 10.42 ± 4.051 ng/mL (P<0.0001). Microalbuminuria levels were significantly higher in the test group, 62.00 ± 61.07 mg/L when compared with control group 21.43 ± 28.09 mg/L (P<0.0001). HbA1c levels were significantly higher in the test group 8.581 ± 1.803 compared with the control group 5.483± 0.4249 (P<0.0001). No significant correlation was found between Glycated hemoglobin (HbA1c) and KIM-1, cystatin C nor microalbuminuria. KIM-1, Cystatin C, Microalbuminuria and Bicarbonate were statistically significantly higher in the test group for both males and females. Creatinine and Urea were statistically significantly higher in the male test group. KIM-1 and Cystatin-C were significantly higher in test groups in all age ranges except 26-35 years. Cystatin-C levels were significantly higher for individuals with over 20 years diabetes diagnosis. Conclusion: The study revealed significantly elevated renal biomarkers in diabetic individuals, independent of glycemic control. the rise in cystatin C with longer disease duration suggests progressive kidney decline. These findings highlight the value of combining multiple biomarkers for early and accurate detection of diabetic kidney disease.