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Background <p>Diabetic kidney disease (DKD) remains a leading cause of end-stage renal disease worldwide. Oxidative stress plays a crucial role in DKD pathogenesis, and 8-hydroxy-2’-deoxyguanosine (8-OHdG), a marker of DNA oxidative damage, may serve as an early predictive biomarker for renal function decline. This study investigated the predictive value of urinary 8-OHdG levels for estimated glomerular filtration rate (eGFR) decline in patients with type 2 diabetes mellitus (T2DM).</p> Methods <p>This retrospective cohort study analyzed data from 386 patients with T2DM and baseline eGFR ≥ 60 mL/min/1.73&#xa0;m² who were followed between January 2020 and December 2024.Participants were followed for 36 months. Urinary 8-OHdG levels were measured by enzyme-linked immunosorbent assay at baseline. The primary outcome was rapid eGFR decline, defined as an annual eGFR reduction ≥ 3.0 mL/min/1.73&#xa0;m²/year. Cox proportional hazards regression, receiver operating characteristic (ROC) analysis, and Kaplan-Meier survival analysis were performed.</p> Results <p>During follow-up, 128 patients (33.2%) experienced rapid eGFR decline. Baseline urinary 8-OHdG levels were significantly higher in patients with rapid decline compared to those without (18.7 ± 4.6 vs. 12.3 ± 3.8 ng/mg creatinine, <i>P</i> &lt; 0.001). After adjusting for traditional risk factors, elevated urinary 8-OHdG (highest tertile) was independently associated with rapid eGFR decline (hazard ratio: 3.42, 95% confidence interval: 2.15–5.44, <i>P</i> &lt; 0.001). The area under the ROC curve for urinary 8-OHdG was 0.786 (95% CI: 0.742–0.826), with optimal cutoff value of 15.2 ng/mg creatinine (sensitivity 78.1%, specificity 72.5%). Combined with clinical variables (age, HbA1c, baseline eGFR, and urinary albumin-to-creatinine ratio), the predictive model achieved an area under the curve of 0.873 (95% CI: 0.837–0.904).</p> Conclusions <p>Elevated urinary 8-OHdG levels independently predict rapid eGFR decline in T2DM patients. Incorporation of urinary 8-OHdG into risk stratification models may enhance early identification of patients at high risk for DKD progression and facilitate timely interventions.</p> Clinical trial number <p>Not applicable.</p>

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Urinary 8-hydroxy-2’-deoxyguanosine as an early predictive biomarker for glomerular filtration rate decline in patients with type 2 diabetes mellitus

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  • 发表日期：

    2026年1月28日

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  • Juan Wu,
  • Ping Sheng,
  • Ying Lu,
  • Ke Chen

摘要

Background

Diabetic kidney disease (DKD) remains a leading cause of end-stage renal disease worldwide. Oxidative stress plays a crucial role in DKD pathogenesis, and 8-hydroxy-2’-deoxyguanosine (8-OHdG), a marker of DNA oxidative damage, may serve as an early predictive biomarker for renal function decline. This study investigated the predictive value of urinary 8-OHdG levels for estimated glomerular filtration rate (eGFR) decline in patients with type 2 diabetes mellitus (T2DM).

Methods

This retrospective cohort study analyzed data from 386 patients with T2DM and baseline eGFR ≥ 60 mL/min/1.73 m² who were followed between January 2020 and December 2024.Participants were followed for 36 months. Urinary 8-OHdG levels were measured by enzyme-linked immunosorbent assay at baseline. The primary outcome was rapid eGFR decline, defined as an annual eGFR reduction ≥ 3.0 mL/min/1.73 m²/year. Cox proportional hazards regression, receiver operating characteristic (ROC) analysis, and Kaplan-Meier survival analysis were performed.

Results

During follow-up, 128 patients (33.2%) experienced rapid eGFR decline. Baseline urinary 8-OHdG levels were significantly higher in patients with rapid decline compared to those without (18.7 ± 4.6 vs. 12.3 ± 3.8 ng/mg creatinine, P < 0.001). After adjusting for traditional risk factors, elevated urinary 8-OHdG (highest tertile) was independently associated with rapid eGFR decline (hazard ratio: 3.42, 95% confidence interval: 2.15–5.44, P < 0.001). The area under the ROC curve for urinary 8-OHdG was 0.786 (95% CI: 0.742–0.826), with optimal cutoff value of 15.2 ng/mg creatinine (sensitivity 78.1%, specificity 72.5%). Combined with clinical variables (age, HbA1c, baseline eGFR, and urinary albumin-to-creatinine ratio), the predictive model achieved an area under the curve of 0.873 (95% CI: 0.837–0.904).

Conclusions

Elevated urinary 8-OHdG levels independently predict rapid eGFR decline in T2DM patients. Incorporation of urinary 8-OHdG into risk stratification models may enhance early identification of patients at high risk for DKD progression and facilitate timely interventions.

Clinical trial number

Not applicable.