The Clinical Utility of SUDOSCAN in Chronic Kidney Disease in Chinese Patients with Type 2 Diabetes.
The Clinical Utility of SUDOSCAN in Chronic Kidney Disease in Chinese Patients with Type 2 Diabetes.
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DOI：
10.1371/journal.pone.0134981
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Chan JC
中科院分区：
文献类型：
--
作者：
Luk AO;Fu WC;Li X;Ozaki R;Chung HH;Wong RY;So WY;Chow FC;Chan JC
关于糖尿病肾病(DKD)定期筛查的建议与临床实践之间存在差距，特别是在繁忙和资源匮乏的环境中。SUDOSCAN(法国巴黎Impeto Medical)是一项非侵入性技术，使用反向离子导入和计时电流法检测异常汗腺功能来评估人体运动功能。血管病变和神经病变具有共同的危险因素，我们推测SUDOSCAN可用于检测慢性肾脏疾病(CKD)。2012至2013年间，对2833名患有2型糖尿病的香港中国成年人进行了SUDOSCAN连续队列检查。慢性肾脏疾病定义为估计的肾小球滤过率&60毫升/分钟/1.73米~2。在这一横断面队列中(平均年龄58.6±9.5岁，男性55.7%，中位病程8[四分位数范围3-14]年)，5.8%患有慢性肾脏病。当SUDOSCAN-DKD评分为53分时，诊断CKD的敏感性为76.7%，特异性为63.4%，阳性似然比为2.1。CKD受试者工作特征曲线下面积为0.75(95%可信区间0.72~0.79)。无CKD但评分较低的患者，其危险因素及并发症较高分者更为严重。我们的结论是，SUDOSCAN可用于检测有肾功能受损风险的患者，作为中国人群筛查计划的一部分，特别是在外展或资源不足的环境中。
There are gaps between recommendations on regular screening for diabetic kidney disease (DKD) and clinical practice especially in busy and low resource settings. SUDOSCAN (Impeto Medical, Paris, France) is a non-invasive technology for assessing sudomotor function using reverse iontophoresis and chronoamperometry which detects abnormal sweat gland function. Vasculopathy and neuropathy share common risk factors and we hypothesized that SUDOSCAN may be used to detect chronic kidney disease (CKD). Between 2012 and 2013, SUDOSCAN was performed in a consecutive cohort of 2833 Hong Kong Chinese adults with type 2 diabetes. Chronic kidney disease was defined as estimated glomerular filtration rate <60 ml/min/1.73m2. In this cross-sectional cohort (mean age 58.6±9.5 years, 55.7% male, median disease duration 8 [interquartile range 3–14] years), 5.8% had CKD. At a cut-off SUDOSCAN-DKD score of 53, the test had sensitivity of 76.7%, specificity of 63.4% and positive likelihood ratio of 2.1 to detect CKD. The area under receiver operating characteristic curve for CKD was 0.75 (95% confidence interval 0.72–0.79). Patients without CKD but low score had worse risk factors and complications than those with high score. We conclude that SUDOSCAN may be used to detect patients at risk of impaired renal function as part of a screening program in Chinese population, especially in outreach or low resource settings.