학술논문
Risk factors for non-diabetic renal disease in diabetic patients
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Report
Author
Bermejo, Sheila; Gonzalez, Ester; Lopez-Revuelta, Katia; Ibernon, Meritxell; Lopez, Diana; Martin-Gomez, Adoracion; Garcia-Osuna, Rosa; Linares, Tania; Diaz, Montserrat; Martin, Nadia; Barros, Xoana; Marco, Helena; Navarro, Maruja Isabel; Esparza, Noem; Elias, Sandra; Coloma, Ana; Robles, Nicolas Roberto; Agraz, Irene; Poch, Esteban; Rodas, Lida; Lozano, Vctor; Fernandez, Beatriz; Hernandez, Eduardo; Martinez, Maria Isabel; Stanescu, Ramona Ionela; Moiron, Jose Pelayo; Garca, Nuria; Goicoechea, Marian; Calero, Francesca; Bonet, Josep; Galceran, Josep M.; Liano, Fernando; Pascual, Julio; Praga, Manuel; Fulladosa, Xavier; Soler, Mara Jose
Source
Clinical Kidney Journal. June 2020, Vol. 13 Issue 3, p380, 9 p.
Subject
Language
English
ISSN
2048-8505
Abstract
INTRODUCTION Diabetes mellitus (DM) is one of the most important health problems in the world and it is dramatically increasing in frequency [1]. One of the reasons is the progressive [...]
Background. Diabetic patients with kidney disease have a high prevalence of non-diabetic renal disease (NDRD). Renal and patient survival regarding the diagnosis of diabetic nephropathy (DN) or NDRD have not been widely studied. The aim of our study is to evaluate the prevalence of NDRD in patients with diabetes and to determine the capacity of clinical and analytical data in the prediction of NDRD. In addition, we will study renal and patient prognosis according to the renal biopsy findings in patients with diabetes. Methods. Retrospective multicentre observational study of renal biopsies performed in patients with diabetes from 2002 to 2014. Results. In total, 832 patients were included: 621 men (74.6%), mean age of 61.7612.8 years, creatinine was 2.862.2 mg/dL and proteinuria 2.7 (interquartile range: 1.2-5.4) g/24h. About 39.5% (n=329) of patients had DN, 49.6% (n=413) NDRD and 10.8% (n=90) mixed forms. The most frequent NDRD was nephroangiosclerosis (NAS) (n=87, 9.3%). In the multivariate logistic regression analysis, older age [odds ratio (OR) = 1.03, 95% CI: 1.02-1.05, P Conclusions. The most frequent cause of NDRD is NAS. Elderly patients with microhaematuria and the absence of DR are the ones at risk for NDRD. Patients with DN presented worse renal prognosis and higher mortality than those with NDRD. These results suggest that in some patients with diabetes, kidney biopsy may be useful for an accurate renal diagnosis and subsequently treatment and prognosis. Keywords: chronic kidney disease, diabetes mellitus, diabetic nephropathy, non-diabetic renal disease, renal biopsy
Background. Diabetic patients with kidney disease have a high prevalence of non-diabetic renal disease (NDRD). Renal and patient survival regarding the diagnosis of diabetic nephropathy (DN) or NDRD have not been widely studied. The aim of our study is to evaluate the prevalence of NDRD in patients with diabetes and to determine the capacity of clinical and analytical data in the prediction of NDRD. In addition, we will study renal and patient prognosis according to the renal biopsy findings in patients with diabetes. Methods. Retrospective multicentre observational study of renal biopsies performed in patients with diabetes from 2002 to 2014. Results. In total, 832 patients were included: 621 men (74.6%), mean age of 61.7612.8 years, creatinine was 2.862.2 mg/dL and proteinuria 2.7 (interquartile range: 1.2-5.4) g/24h. About 39.5% (n=329) of patients had DN, 49.6% (n=413) NDRD and 10.8% (n=90) mixed forms. The most frequent NDRD was nephroangiosclerosis (NAS) (n=87, 9.3%). In the multivariate logistic regression analysis, older age [odds ratio (OR) = 1.03, 95% CI: 1.02-1.05, P Conclusions. The most frequent cause of NDRD is NAS. Elderly patients with microhaematuria and the absence of DR are the ones at risk for NDRD. Patients with DN presented worse renal prognosis and higher mortality than those with NDRD. These results suggest that in some patients with diabetes, kidney biopsy may be useful for an accurate renal diagnosis and subsequently treatment and prognosis. Keywords: chronic kidney disease, diabetes mellitus, diabetic nephropathy, non-diabetic renal disease, renal biopsy