Clinical pathological characteristics and predictive index of kidney injury in patients with type 2 diabetes mellitus
Objective To discuss clinical or laboratory indicators that can predict diabetic kidney disease(DKD)and diabetes patients with non-diabetic kidney disease(NDKD).Methods A total of 130 cases type 2 diabetes mellitus with renal injury confirmed by renal biopsy from January 2017 to December 2021 in the Department of Nephrology,the Second Hospital of Lanzhou University were retrospectively analyzed.According to the pathological type of kidney,the patients were divided into three groups:DKD group(77 cases),NDKD group(34 cases),and DKD+NDKD group(19 cases).Clinical or laboratory indicators among three groups were compared.Multivariate Logistic regression was used to analyze the independent risk factors of DKD and NDKD,receiver operating characteristic(ROC)curve was used to predict sensitivity and specificity of DKD and NDKD.Results Primary glomerulonephritis was the main type of renal injury in type 2 diabetes mellitus patients with NDKD,of which IgA nephropathy was the most common pathological type,followed by membranous nephropathy and minimal change glomerulonephritis.Single factor analysis of variance showed that compared with DKD group,NDKD group had a shorter history of diabetes,and a lower proportion of diabetes retinopathy and impaired cardiac diastolic function.Multivariate Logistic regression analysis found that the history of diabetes and diabetes retinopathy were risk factors for predicting DKD and NDKD.ROC curve analysis showed that the history of diabetes＜6.5 years and no diabetes retinopathy could be used as clinical indicators to better predict NDKD.Conclusion NDKD is a common type of type 2 diabetes mellitus with renal injury.The short history of diabetes and no diabetes retinopathy suggest that it may be NDKD,and renal biopsy should be performed in time to make a clear diagnosis.
Diabetic kidney diseaseDiabetes combined with non-diabetic kidney diseaseDiabetes retinopathyHistory of diabetesRenal biopsyPathology
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