Abstracts P=0.0008), U24Glu and U24A (RS=0.461; P=0035), UA and miRNA-21 (RS=0.536; P=0.032) were observed. CONCLUSIONS: One cannot exclude that the iSGLT-2 may have some negative direct effect on the kidneys. However, possible negative effects of these drugs on the kidneys in diabetes mellitus may overlap its counteraction to hyperglycemia and glomerular hyperﬁltration. MP505 APLICATION OF SERUM CYSTATIN C FOR PREDICTION OF NEPHROPATHY AND CARDIOVASCULAR DISEASES IN PATIENTS WITH TYPE 2 DIABETES MELLITUS Nevi Pasko4, Ariana Strakosha3, Florian Toti2, Vilma Cadri3, Suela Mumajesi3, Teuta Dedej1, Enkeleda Stefa3, Myftar Barbullushi3 1 Biochemistry University Hospital Center Tirana Albania, 2Endocrinology University Hospital Center Tirana Albania, 3Nephrology University Hospital Center Tirana Albania and 4Nephrology University Hospital Center, Tirana Tirana Albania INTRODUCTION AND AIMS: Diabetes mellitus is a major health issue associated with an increase of morbidity and mortality primarily due to micro and macro vascular complications. The use of a reliable marker of diabetic nephropathy and cardiovascular diseases in diabetic patients could help to identify individuals with high risk. Cystatin C has recently been proposed as a marker of renal function and as a predictor of cardiovascular risk. The aim of this study was to evaluate the serum cystatin C and its correlation with cardiovascular risk factors in diabetic patients. METHODS: The study was carried out in 86 type 2 diabetic patients divided in three groups: with microalbuminuria (n = 26), macroalbuminuria (n = 28), and diabetic patients without evidence of cardiovascular and renal complications (n = 32). A detailed questionnaire was used to record the medical history of the patients. Serum Cystatin C was measured by Elisa method while microalbuminuria by immunoturdimetric assay. Lipid proﬁle, C-reactive protein, ﬁbrinogjen, and estimated glomerular ﬁltration rate were measured. RESULTS: The study showed that serum cystatin C increased with increasing degree of albuminuria and become statistically signiﬁcant in patients with macroalbuminuria versus microalbuminuria 2.5760.71 (p<0.001). The serum cystatin C level was higher in patients with eGFR < 60 mL/min/1.73 m2 (2.8060.43 mg/l versus 1.2860.69 mg/l, p<0.001). We found a positive correlation of serum cystatin C with cardiovascular risk markers: C-reactive protein (r =0.85), HDL (r = 0.91), LDL (r = 0.75) and ﬁbrinogjen (0.71). CONCLUSIONS: Cystatin C is a practical and non-invasive method for the evaluation of renal impairment among diabetic patients especially in normoalbuminuric patients. Serum Cystatin C can be used as an alternative to urinary albumin excretion and serum creatine in screening for renal impairement in type 2 diabetic patients. Serum Cystatin C may be used as potential predictor of cardiovascular disease in diabetic patients. MP506 A COUPLE OF DRUGS WITH A POTENTIAL RENOPROTECTIVE EFFECT Filipa Brito Mendes1, Luısa Helena Pereira1, Ana Paula Silva1,2, Pedro Neves2,1 Nephrology Algarve Hospital Centre Faro Portugal and 2Biomedical Science Algarve University Faro Portugal 1 INTRODUCTION AND AIMS: Diabetes Mellitus is the main cause of CKD and consequently a cause of high morbidity and mortality. Albuminuria is an important marker of disease progression and represents a target of control as well as a support for iii614 | Abstracts Nephrology Dialysis Transplantation investigation, in order to ﬁnd the optimal antiproteinuric drug. Vitamin D analogues, such as paricalcitol has shown antiproteinuric effect in different animal models through a renin suppression, regulation of inﬂammation, action on podocytes, and antiapoptotic function. Other drug which is under investigation attending the possibility of albuminuria reduction is the dipeptidyl peptidase 4 (DPP4) inhibitors. Suggested mechanisms for it seems to be the anti oxidative effect and reduction of reactive oxygen species through the up regulation of the renal cyclic adenosine monophosphate (cAMP). The aim of this study is to investigate the role of paricalcitol and DPP4 inhibitors in type 2 diabetic patients with renal disease having in mind the albumin-creatinine ratio (ACR) at baseline, 3 months and 6 months. METHODS: A randomized study included 120 patients, followed in diabetic nephropathy clinic. The population was divided into four groups according to the diabetic medication:G1= Linagliptin + gliclazide; G2=Paricalcitol + DPP4 inhibitors; G3=paricalcitol + linagliptin and G4= unchanged medication (gliclazide+ metformin). Continuous variables description, ANOVA and chi-square test were used for comparison between groups. ANCOVA, LSD post-Hoc test. RESULTS: The mean age of these patients, the gender and the body mass index were similar between groups. The groups presented with different time-evolution of diabetes, with G2 being the group with a shorter time-evolution diabetes 6.8 (61.6) years, p=0.001 and G3 with the longer time-evolution diabetes 10.6 (64)years, p=0.001, statistically signiﬁcant. At the baseline the mean ACR was: G1=257.3 (6119.4); G2=269.5 (6114.3); G3=292.8 (671.5); G4=189.2 (658.4).The adjusted mean ACR difference revealed that ACR levels had signiﬁcantly decreased 6 months after starting any medication, except for the group without medication alteration that showed a signiﬁcant increase in ACR levels. 3rd month: G1 Vs G4 -39.7, 95% CI: -75; -4.3 p=0.028; G2 Vs G4 -71.3, 95% C.I: -106.7; -36.0 p<0.001; G3 Vs G4 -45.4 95% CI: -80.8; -10.1 p=0.012. 6th months G1 Vs G4 -102, 95% CI: -142.5; -61.4 p<0.001; G2 Vs G4 -153.2, 95% C.I: 106.7; -36 p<0.001; G3 Vs G4 -148.6, 95% CI: -189.2; -108.1 p<0.001. CONCLUSIONS: According to our results, the association of paricalcitol and DPP4 inhibitors revealed a positive effect on the decrease of ACR. Nevertheless, more studies should be designed in order to better understand the individual role of each drug. Other question to be addressed is if the improvement of ACR comes together with an improvement of GFR, culminating in a true renoprotective role. MP507 SERUM ANGIOPOIETIN LIKE 2 AND PROGRESSION OF DIABETIC NEPHROPATHY Makiko Konishi1, Fumihiko Furuya1, Tetsuharu Oku1, Takeyuki Takamura1, Kenichiro Kitamura1 1 Third Department of Internal Medicine University of Yamanashi Chuo Japan INTRODUCTION AND AIMS: Angiopoietin-like protein 2 (Angptl2) is an adiopokine which was secreted by adipose tissue and that its circulating level was closely related to adiposity, systemic insulin resistance, and inﬂammation in both mice and humans. We assessed the relationship between Angptl2 and the prevalence of the progression of diabetic nephropathy (DN). METHODS: One hundred forty eight diabetes patients were followed up for 7 years. Logistic regression models for the progression at every stage of DN were used to evaluate the predictive value of Angptl2. The potential beneﬁt of using Angptl2 alone or together with albumin excretion rate (AER) and eGFR was assessed by receiver operating characteristic (ROC) curve analysis. Furthermore, we investigated the effects of Angptl2 on podocyte in vitro. Progression of DN was deﬁned as the passage from one stage to the next based on AER. End-stage renal disease (ESRD) was deﬁned as the requirement of dialysis or kidney transplantation. RESULTS: The odds ratio for the prevalence of the presence diabetes, fatty changes of liver, and chronic kidney disease increased with higher serum Angptl2 levels. Cohort study indicated that baseline of Anptl2 was an independent predictor of progression at all stages of DN. In cultured podocytes, recombinant Angptl2 reduced the expression of podocin and translocation of zona occludens-1 in the membrane. CONCLUSIONS: Angptl2 is an independent predictor of progression of DN irrespective of disease stage via modulation of oxidative stress in podocytes.