Quantitative, Targeted Analysis of Gut Microbiota Derived Metabolites Provides Novel Biomarkers of Early Diabetic Kidney Disease in Type 2 Diabetes Mellitus Patients

Diabetic kidney disease (DKD) is one of the most debilitating complications type 2 diabetes mellitus (T2DM), as it progresses silently to end-stage renal (ESRD). The discovery novel biomarkers early DKD becomes acute, its incidence reaching catastrophic proportions. Our study aimed quantify previously identified metabolites from serum and urine through untargeted ultra-high-performance liquid chromatography coupled with electrospray ionization-quadrupole-time flight-mass spectrometry (UHPLC-QTOF-ESI+-MS) techniques, such following: arginine, dimethylarginine, hippuric acid, indoxyl sulfate, p-cresyl L-acetylcarnitine, butenoylcarnitine sorbitol. concept was based on targeted analysis selected metabolites, using 20 healthy subjects 90 T2DM patients in different stages (normoalbuminuria—uACR < 30 mg/g; microalbuminuria—uACR 30–300 macroalbuminuria—uACR > 300 mg/g). quantitative evaluation performed pure standards, followed by validation methods limit detection (LOD) quantification (LOQ). following this resulted possible DKD: serum—arginine, sorbitol urine—p-cresyl sulfate.