Nondiabetic Renal Disease in type 2 Diabetes Mellitus Patients: A Clinicopathological Study.
Nondiabetic Renal Disease in type 2 Diabetes Mellitus Patients: A Clinicopathological Study.
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DOI：
10.4103/0974-2727.119850
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发表时间：
2013-07
影响因子：
1.1
通讯作者：
Subramanyan R
中科院分区：
文献类型：
--
作者：
Wilfred DC;Mysorekar VV;Venkataramana RS;Eshwarappa M;Subramanyan R
2 型糖尿病患者中非糖尿病肾病 (NDRD) 的患病率差异很大，具体取决于所研究的人群和选择标准。此外，对于发现患有 NDRD 的患者，不同的研究已经确定了不同的预测因素。确定：(i) 在我们的研究中，患有非典型临床肾病的 2 型糖尿病患者的 NDRD 频率和谱，以及 (ii) 在我们当地人群中与 NDRD 相关的常见临床标志物。招募了 93 名患有非典型临床肾脏疾病的 2 型糖尿病患者，他们接受了肾活检以排除 NDRD。患者被分为第 1 组（孤立性 NDRD）、第 2 组（NDRD 叠加糖尿病肾病（DN））和第 3 组（孤立性 DN）；采用方差分析、Kruskal-Wallis检验和统计显着性卡方检验对其临床和生化参数进行统计分析。 68.8% 的患者患有 NDRD，伴或不伴并发 DN。与其他组相比，孤立性 NDRD 患者的糖尿病病程较短。在 2 型糖尿病患者中，不存在视网膜病变以及存在镜下血尿和活动性尿沉渣对 NDRD 的阳性预测值分别为 79.24、81 和 100%。在我们的研究中，慢性间质性肾炎是最常见的 NDRD，膜性肾小球肾炎是最常见的肾小球 NDRD。在我们的研究中，患有非典型临床肾脏疾病的 2 型糖尿病患者中 NDRD 的发生率很高，因此必须进行肾活检程序来排除这种情况。糖尿病病程较短、无视网膜病变、存在镜下血尿和活动性尿沉渣是与伴有临床肾病的 2 型糖尿病 NDRD 相关的标志物。
The prevalence of nondiabetic renal disease (NDRD) among type 2 diabetics varies widely depending on the populations being studied and the selection criteria. Also, for patients found to have NDRD different predicting factors have been identified by different studies. To determine: (i) Frequency and spectrum of NDRD in type 2 diabetics with atypical clinical renal disease, in our set up and (ii) common clinical markers that are associated with NDRD in our local population. Ninety-three type 2 diabetic patients with atypical clinical renal disease who had undergone renal biopsy to rule out NDRD were recruited. Patients were grouped into Group 1 with isolated NDRD, Group 2 with NDRD superimposed on diabetic nephropathy (DN), and Group 3 with isolated DN; and their clinical and biochemical parameters were statistically analyzed using analysis of variance, Kruskal-Wallis test, and Chi-square tests of statistical significance. 68.8% of the patients had NDRD with or without concurrent DN. Patients with isolated NDRD had shorter duration of diabetes compared to the other groups. Absence of retinopathy and presence of microscopic hematuria and active urinary sediment had positive predictive value of 79.24, 81, and 100%, respectively, for NDRD in type 2 diabetics. Chronic interstitial nephritis was the commonest NDRD and membranous glomerulonephritis was the commonest glomerular NDRD in our setup. The frequency of NDRD in type 2 diabetics with atypical clinical renal disease is high in our setup thereby making the renal biopsy procedure imperative to rule out the same. Shorter duration of diabetes, absence of retinopathy, presence of microscopic hematuria, and active urinary sediment are markers associated with NDRD in type 2 diabetes with clinical renal disease.