Fibrinogen to albumin ratio as a risk factor for type 2 diabetic nephropathy

Background Diabetic nephropathy (DN), a leading cause of chronic kidney disease and end-stage kidney disease, is a serious complication of type 2 diabetes mellitus (T2DM). This study aims to investigate the association between fibrinogen/albumin ratio (FAR) and T2DM and evaluate its utility as a novel predictive biomarker for DN progression. Patients and methods A cross-sectional comparative study was conducted on T2DM patients with and without DN. Patients were stratified into groups based on chronic kidney disease stages and FAR tertiles. Clinical, demographic, and biochemical data, including fibrinogen, albumin, and FAR, were collected and analyzed. Correlations between FAR and DN severity were evaluated using multivariate logistic regression models, spline regression, and receiver operating characteristic curve analysis to assess FAR’s predictive accuracy. Results The study revealed a significant positive correlation between FAR and DN progression. Higher FAR values were associated with advanced chronic kidney disease stages, elevated albuminuria, reduced estimated glomerular filtration rate, and poorer clinical outcomes. Multivariate analysis identified FAR as an independent predictor of DN after adjusting for confounders, including age, Basal Metabolic Index, hemoglobin A1c, and diabetes duration. Receiver operating characteristic curve analysis demonstrated that FAR outperformed traditional markers like fibrinogen and albumin alone in predicting DN. Conclusion FAR may be a reliable and robust biomarker for predicting DN progression in T2DM. Its combination of inflammatory and nutritional/metabolic indicators offers superior prognostic value compared to traditional markers. Incorporating FAR into routine clinical practice could enhance early detection and risk stratification of DN, enabling timely therapeutic interventions and improved patient outcomes.