Clinical predictors for nondiabetic kidney diseases in patients with type 2 diabetes mellitus: a retrospective study from 2017 to 2021.
Clinical predictors for nondiabetic kidney diseases in patients with type 2 diabetes mellitus: a retrospective study from 2017 to 2021.
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2型糖尿病患者非糖尿病肾病的临床预测因素：2017 - 2021年的回顾性研究。
DOI：
10.1186/s12902-022-01082-8
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发表时间：
2022-06-30
影响因子：
2.7
通讯作者：
Yan, Rui
中科院分区：
文献类型：
--
作者：
Zeng, Yong-qin;Yang, Yu-xing;Guan, Cheng-jing;Guo, Zi-wei;Li, Bo;Yu, Hai-yan;Chen, Rui-xue;Tang, Ying-qian;Yan, Rui
关键词：
非糖尿病肾病（NDKD）常见于糖尿病（DM）患者，其病理特征、治疗策略和预后与糖尿病肾病（DKD）有很大不同。尽管肾活检是目前的金标准诊断方法，但由于存在一系列风险，无法常规进行。本研究的目的是探索区分 NDKD 和 DKD 的预测因子，以满足无法负担肾活检费用的患者的紧急医疗需求。这是一项回顾性研究，回顾性研究2017年1月至2021年5月在贵州医科大学附属医院接受经皮肾活检的2型糖尿病患者的病历。从病历中获取患者的人口学资料、临床资料、血液检查结果和病理检查结果。进行多变量回归分析以评估 NDKD 的预测因素。总共分析了 244 名患者。活检时的中位年龄为 55 (46, 62) 岁。诊断为真性 DKD 的患者、诊断为 NDKD 的患者以及诊断为 NDKD 叠加 DKD 的患者分别占患者群体的 48.36%（118/244）、45.9%（112/244）和 5.74%（14/244）。免疫球蛋白 A 肾病是 NDKD 患者（59 例，52.68%）和 NDKD 叠加 DKD 患者（10 例，71.43%）中最常见的病变类型。诊断 NDKD 的独立预测指标包括糖尿病病程少于 5 年（比值比 [OR] = 4.476；95% 置信区间 [CI]：2.257–8.877；P < 0.001）、不存在糖尿病视网膜病变（OR = 4.174；95% CI： 2.049–8.502；P < 0.001），高红细胞计数（OR = 1.901；95% CI：1.251–2.889；P = 0.003），尿糖排泄测试结果阴性（OR = 2.985；95% CI： 1.474–6.044；P = 0.002).. DM 病程少于 5 年、无视网膜病变、高红细胞计数和无尿葡萄糖排泄是诊断 NDKD 的独立指标，表明 NDKD 患者可能需要与 DKD 患者不同的治疗方案。
Nondiabetic kidney disease (NDKD), which is prevalent among patients with diabetes mellitus (DM), is considerably different from diabetic kidney disease (DKD) in terms of the pathological features, treatment strategy and prognosis. Although renal biopsy is the current gold-standard diagnostic method, it cannot be routinely performed due to a range of risks. The aim of this study was to explore the predictors for differentiating NDKD from DKD to meet the urgent medical needs of patients who cannot afford kidney biopsy. This is a retrospective study conducted by reviewing the medical records of patients with type 2 DM who underwent percutaneous renal biopsy at the Affiliated Hospital of Guizhou Medical University between January 2017 and May 2021. The demographic data, clinical data, blood test results, and pathological examination results of the patients were obtained from their medical records. Multivariate regression analysis was performed to evaluate the predictive factors for NDKD. A total of 244 patients were analyzed. The median age at biopsy was 55 (46, 62) years. Patients diagnosed with true DKD, those diagnosed with NDKD and those diagnosed with NDKD superimposed DKD represented 48.36% (118/244), 45.9% (112/244) and 5.74% (14/244), respectively, of the patient population. Immunoglobulin A nephropathy was the most common type of lesion in those with NDKD (59, 52.68%) and NDKD superimposed DKD (10, 71.43%). Independent predictive indicators for diagnosing NDKD included a DM duration of less than 5 years (odds ratio [OR] = 4.476; 95% confidence interval [CI]: 2.257–8.877; P < 0.001), an absence of diabetic retinopathy (OR = 4.174; 95% CI: 2.049–8.502; P < 0.001), a high RBC count (OR = 1.901; 95% CI: 1.251–2.889; P = 0.003), and a negative of urinary glucose excretion test result (OR = 2.985; 95% CI: 1.474–6.044; P = 0.002).. A DM duration less than 5 years, an absence of retinopathy, a high RBC count and an absence of urinary glucose excretion were independent indicators for the diagnosis of NDKD, suggesting that patients with NDKD may require a different treatment regimen than those with DKD.
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影响因子：
4.6
作者：
Hung CC;Lin HY;Hwang DY;Kuo IC;Chiu YW;Lim LM;Hwang SJ;Chen HC
通讯作者：
Chen HC
影响因子：
16.2
作者：
American Diabetes Association
通讯作者：
American Diabetes Association
影响因子：
1.1
作者：
Wilfred DC;Mysorekar VV;Venkataramana RS;Eshwarappa M;Subramanyan R
通讯作者：
Subramanyan R
影响因子：
2
作者：
Liu, Shujun;Guo, Qiaoyan;Han, Hongbo;Cui, Peihe;Liu, Xiao;Miao, Lining;Zou, Hongbin;Sun, Guangdong
通讯作者：
Sun, Guangdong
参考病程和结果，识别中国 2 型糖尿病患者糖尿病肾病和非糖尿病肾病的临床预测因子。
影响因子：
3.8
作者：
Wang, Jiali;Han, Qianqian;Liu, Fang
通讯作者：
Liu, Fang