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Abstract Background Hyperhomocysteinemia has been linked with chronic kidney disease (CKD). The present study investigated whether homocysteine (Hcy) serum levels might serve as a marker for the advancement of diabetic nephropathy (DN). Methods Clinical and laboratory indicators including Hcy, vitamin D (VD), urine protein, estimated glomerular filtration rate (eGFR) and the urinary protein/creatinine ratio in subjects > 65 years with DN (n = 1,845), prediabetes (n = 1,180) and in a non-diabetes (control) group (n = 28,720) were analyzed. Results DN patients had elevated Hcy concentrations, decreased VD and higher urinary protein levels, a reduced eGFR and a higher urinary protein/creatinine ratio compared with prediabetic and control subjects. After correcting for urinary protein quantitation, multivariate analysis revealed that both the Hcy concentration (P 12 µmol/L was a cut-off value for predicting advanced DN. Conclusion Hcy serum concentration is a potential marker for the advancement of CKD in DN but not prediabetes patients.

Doença renal crônica (DRC) é a forma mais comum de doença renal em gatos. Vários fatores têm sido citados como importantes na progressão da doença, dentre eles a proteinúria. A relação proteína-creatinina (RPC) urinária em uma única amostra de urina apresenta boa correlação com a perda de proteína urinária em 24 horas. O objetivo dessa investigação foi determinar a RPC urinária em gatos com DRC adquirida naturalmente. A determinação da RPC foi realizada em nove gatos saudáveis (Grupo I) e em trinta gatos com DRC (Grupo II). Os gatos do Grupo I apresentaram RPC de 0,16±0,10 e os gatos do Grupo II apresentaram RPC de 0,53± 0,59. No Grupo II encontrou-se correlação positiva e significante da RPC com o nível de creatinina sérica. Os resultados deste estudo demonstram que a RPC urinária em gatos com DRC é bastante variável e que, à semelhança do que já havia sido previamente descrito, aproximadamente um terço dos gatos com DRC são considerados proteinúricos segundo critérios estabelecidos pela literatura (RPC urinária >0,4).Chronic renal disease (CRD) is the most common form of renal disease in cats. Several factors contribute to disease progression. Proteinuria is an important marker of renal disease progression. The protein-creatinine ratio in a single urine sample correlates well with urinary protein loss in 24 hours. The aim of this investigation was to determine the urine protein-creatinine (UPC) ratio in cats with natural acquired chronic renal disease. The UPC ratio was performed in nine clinically normal cats and in 30 cats with chronic renal disease. Mean UPC ratio in normal cats was 0.16±0.10, and mean UPC ratio in the cats with chronic renal disease was 0.53± 0.59. In the group with renal disease there was positive correlation between UPC ratio and serum creatinine levels. The results obtained from this study demonstrate that UPC ratio in cats with CRD is variable and that, in accordance to what has previously been described, approximately one third of the cats with CRD are considered proteinuric according to the criteria established in literature (UPC ratio > 0.4).