A recent study published in Diabetology and Metabolic Syndrome demonstrated the prognostic value of Podocyte mitochondrial changes (PMC) and elevated urinary MDM2/creatinine (MDM2/Cr) levels in patients with diabetic kidney disease (DKD).
The progression and prognosis of diabetic nephropathy (DN) are mediated by Podocytic injury and shedding. The study aimed to investigate heterokaryotic podocytes resulting from mitotic failure and to measure the levels of double minute gene 2 (MDM2) and synaptopodin (SP) in the urine of patients with diabetic kidney disease (DKD) to explore their diagnostic efficacy in this condition.
Researchers selected diabetic patients and examined the urine samples of each patient. The presence of urinary podocytes and podocyte mitosis catastrophe (PMC), along with their correlation with various indicators, was determined. Immunofluorescence (IF) was used to determine Podocytes in urine sediment.  Enzyme-linked immunosorbent assay (ELISA) kits were used to detect the expression of MDM2 and SP in urine supernatant.
Results showed that even during the period of normal albuminuria, podocytes might have been damaged in diabetic patients. Urinary and heterolytic podocyte counts positively correlated with urinary SP level. With an increase in albuminuria level and heterolytic podocyte count, there was a consistent upregulation of MDM2 in urine. Study demonstarted a higher sensitivity of urinary MDM2 to creatine (MDM2/Cr) and a higher specificity of urinary SP to creatinine (SP/Cr) in DKD diagnosis. This combination showed greater diagnostic efficacy than either one alone.