The clinicopathological characteristics of diabetic nephropathy and non-diabetic renal diseases in diabetic patients
10.3760/cma.j.issn.0578-1426.2017.12.007
- VernacularTitle:糖尿病肾病与伴糖尿病的非糖尿病肾脏疾病患者临床病理特征分析
- Author:
Jing XU
1
;
Xiaofan HU
;
Wei HUANG
;
Pingyan SHEN
;
Wen ZHANG
;
Hong REN
;
Xiao LI
;
Weiming WANG
;
Nan CHEN
;
Xiaoxia PAN
Author Information
1. 200025,上海交通大学医学院附属瑞金医院肾脏科上海交通大学医学院肾脏病研究所
- Keywords:
Diabetic nephropathy;
Non-diabetic renal diseases;
Pathology;
clinical
- From:
Chinese Journal of Internal Medicine
2017;56(12):924-929
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinicopathological characteristics of renal lesions in type 2 diabetic patients and to differentiate diabetic nephropathy (DN) from non-diabetic renal diseases (NDRD).Methods Type 2 diabetic patients who received renal biopsy in Ruijin Hospital from January 2011 to December 2015 were recruited in this study. Clinical history, laboratory results and pathological data were retrospectively collected. According to the pathological findings, the patients were divided into 3 groups: DN, NDRD, DN+NDRD. Logistic model was applied to explore the independent clinical predictive factors in differentiating DN from NDRD. Results A total of 207 type 2 diabetic patients received renal biopsy, accounting for 6.82% of all biopsy population. Fifty-one patients were diagnosed with DN, 142 with NDRD and 14 with both DN and NDRD. In NDRD, membranous nephropathy(MN) (34.5%) was the most common finding, followed by IgA nephropathy(19.7%).By contrast, NDRD patients manifested a shorter diabetic course, a higher baseline hemoglobin level, a lower baseline serum creatinine, a higher prevalence of hematuria, a lower prevalence of hypertension and diabetic retinopathy, a better control of blood glucose, better compliance of monitoring blood glucose and less family history of diabetes. In multivariate logistic model, diabetic family history(OR=4.68, P=0.04) and long history of diabetes(OR=1.01, P=0.02) were risk factors of DN. Conclusion There is a high prevalence of NDRD in diabetic patients with renal lesions. Family history of diabetes and duration of diabetes are independent predictors of DN.
