The following is a summary of the “Urinary and Kidney Podocalyxin and Podocin Levels in Diabetic Kidney Disease: A Kidney Biopsy Study,” published in the January 2023 issue of Kidney Medicine by Zeng, et al.

When it comes to kidney failure requiring dialysis, diabetes-related kidney disorders (DKDs) are by far the most common culprit. There has been speculation that the amount of podocyte-associated chemicals in the urine can be used to foretell the outcome of DKD.

There was a strong correlation between the urinary podocalyxin level and its mRNA level (r = 0.562, P<0.001). However, this could not be used to predict the development of DKD. 

An independent predictor of dialysis-free survival (adjusted HR, 1.85; 95% CI, 1.21-2.82; P = 0.005), and a non-significant trend towards predicting kidney event-free survival (adjusted HR, 1.36; 95% CI, 0.94-1.95; P = 0.10), intrarenal podocalyxin level showed only modest correlation with its urinary mRNA and enzyme-linked immunosorbent assay (ELISA) levels. The ELISA-measured urinary podocin level was inversely related to the rate of decrease in kidney function (r = 0.238, P = 0.01) but was not predictive of dialysis-free survival.

Urinary podocin level by ELISA was linked with the rate of kidney function deterioration, but intrarenal podocalyxin level was an independent predictor of dialysis-free survival. The predictive usefulness of measuring intrarenal podocalyxin level is likely outweighed by the fact that it is not yet ready for widespread clinical use.