Diabetic kidney disease (DKD) is the most common cause of CKD. A spot urine albumin-creatinine ratio (UACR) and serum creatinine are used as an indicator of DKD progression. These indicators may not reflect the renal damage of early DKD. The N-acetyl-β-D-glucosaminidase (NAG) is found in the lysosomes of renal proximal tubular cells and the urinary NAG can reflect even subclinical tubular damage. Expression of sodium-glucose cotransporter 2 (SGLT2) is prominently increased in diabetes. This can increase urinary excretion of NAG, involved in carbohydrate metabolism.
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Jung et al. (2024) studied this question.
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