K. Kashiwabara et al., Mechanism of increased serum cytokeratin 19 fragment levels in patients with diabetic nephropathy as a model of chronic renal failure, INTERN MED, 37(11), 1998, pp. 917-921
We examined serum and urinary cytokeratin 19 fragment (CYFRA 21-1) levels i
n patients with diabetic nephropathy as a model of chronic renal failure, t
o investigate the mechanism of increased serum CYFRA 21-1 levels in chronic
renal failure. Serum and urinary CYFRA 21-1 levels in non-insulin-dependen
t diabetes mellitus (NIDDM) patients with abnormal urinary immunoglobulin G
(IgG) levels (>1.1 mg/g Cr, n=126) were higher than those with normal urin
ary IgG levels. In NIDDM patients with normal urinary IgG levels (n=81); th
e urinary albumin or transferrin levels were not related to serum or urinar
y CYFRA 21-1 levels. We speculate that the increased serum CYFRA 21-1 level
s contribute to metabolic abnormality in the kidney itself rather than the
decreased urinary excretion per se, and that increased urinary CYFRA 21-1 l
evels are found in advanced cases of diabetic nephropathy with destruction
of the size barrier.