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Dr Ali Raza, Dr Qurat ul Ain, Dr Aqsa Rafiq
Introduction: Characteristic features of chronic kidney disease (CKD) involve progressive destruction of the renal parenchyma and the loss of functional nephrons. The loss of functional nephrons triggers molecular and cellular events responsible for compensatory growth of the remaining ones. Aims and objectives: The main objective of the study is to analyze the serum levels of traditional renal biomarkers for the early detection of pre-hypertensive nephropathy. Methodology of the study: This cross sectional study was conducted at THQ Hospital, Daska during September 2018 to January 2018. Those with slightly raised serum creatinine and those with blood sugar levels within pre-diabetes range on previous reports were excluded, and so were those who gave history of antihypertensive medication or use of steroid. Informed consent was taken from all study participants. Results: Of the 90 individuals initially enrolled, 12(13.3%) were excluded, leaving the study sample to be 78(86.6%). Of them, 39(50%) were normotensive in group 1 and (50%) in pre-hypertensive group 2. There were 33(84.6%) males and 6 (15.4%) females in group 1, and 36(92.3%) males and 3(7.7%) females in group 2. Serum Cystatin-C levels were 0.91 mg/l in group 1 and 1.55 mg/l in group 2 (p=0.0001) whereas serum creatinine difference in both groups remained statistically non-significant (p=0.977). Conclusion: It is concluded that diagnostic markers which reflect renal impairment at early stage is important as early intervention can slow the loss of kidney function and reduce adverse clinical outcomes. Serum cystatin C rise faster than SCr after a fall in GFR and has the potential to accurately detect earlier changes in GFR compared to SCr, serving as an excellent endogenous marker of early renal dysfunction in type 2 diabetes.