To investigate the changes of renal type IV collagen turnover in diabetic n
ephropathy, urinary type IV collagen was measured by a highly sensitive one
-step sandwich enzyme immunoassay (EIA). Urinary samples were obtained from
698 diabetic patients and 191 healthy adults. Among the patients, 264 had
urinary albumin levels of less than 29 mg/g.creatine (Cr) (Stage I: normoal
buminuric stage), 169 had microalbuminuria from 30 to 299 mg/g.Cr (Stage II
: microalbuminuric stage), 84 patients had macroalbuminuria of more than 30
0 mg/g.Cr and serum Cr of less than 1.1 mg/dl (Stage IIIA: macroalbuminuric
stage without renal dysfunction), 97 had macroalbuminuria of more than 300
mg/g.Cr and serum Cr of more than 1.2 mg/dl (Stage IIIB: macroalbuminuric
stage with renal dysfunction), and 84 had renal failure (Stage IV). The lev
els of urinary type IV collagen in Stages II, IIIA, IIIB, and IV were signi
ficantly higher than those in Stage I (P < 0.0001). The level of urinary ty
pe IV collagen in Stage I (5.00 +/- 0.23 mug/g Cr; mean +/- SE) was also hi
gher than that in normal adults (3.44 +/- 0.11 mug/ g.Cr; mean +/- SE). The
se levels increased gradually due to progression of the clinical stage of d
iabetic nephropathy. It appears that the levels of urinary type IV collagen
can be a useful marker for detecting renal injuries in diabetes according
to our Asian multicenter trials. (C) 2001 Wiley-Liss, Inc.