دورية أكاديمية
أعرض في EDS

Risk factors for non-diabetic renal disease in diabetic patients.

التفاصيل البيبلوغرافية
العنوان: Risk factors for non-diabetic renal disease in diabetic patients.
المؤلفون: Bermejo S; Nephrology Department, Hospital del Mar, Barcelona, Spain.; Nephrology Department, Fundació Althaia, Manresa, Spain., González E; Nephrology Department, Hospital 12 de Octubre, Madrid, Spain., López-Revuelta K; Nephrology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain., Ibernon M; Nephrology Department, Hospital Sant Joan Despí Moisès Broggi, Barcelona, Spain., López D; Nephrology Department, Clínica Universitaria de Navarra, Pamplona, Spain., Martín-Gómez A; Nephrology Department, Hospital de Poniente, Almería, Spain., Garcia-Osuna R; Nephrology Department, Hospital de Palamós, Girona, Spain., Linares T; Nephrology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain., Díaz M; Nephrology Department, Fundació Puigvert, Barcelona, Spain., Martín N; Nephrology Department, Hospital Universitari Josep Trueta, Girona, Spain., Barros X; Nephrology Department, Hospital Universitari Josep Trueta, Girona, Spain., Marco H; Nephrology Department, Hospital Germans Trias i Pujol, Badalona, Spain., Navarro MI; Nephrology Department, Hospital Germans Trias i Pujol, Badalona, Spain., Esparza N; Nephrology Department, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain., Elias S; Nephrology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain., Coloma A; Nephrology Department, Hospital San Pedro, Logroño, Spain., Robles NR; Nephrology Department, Hospital Infanta Cristina, Badajoz, Spain., Agraz I; Nephrology Department, Hospital Vall d'Hebron, Barcelona, Spain., Poch E; Nephrology Department, Hospital Clínic, Barcelona, Spain.; IDIBAPS, Universitat de Barcelona, Barcelona, Spain., Rodas L; Nephrology Department, Hospital Clínic, Barcelona, Spain.; IDIBAPS, Universitat de Barcelona, Barcelona, Spain., Lozano V; Nephrology Department, Hospital Clínic, Barcelona, Spain.; IDIBAPS, Universitat de Barcelona, Barcelona, Spain., Fernández B; Nephrology Department, Fundación Jiménez Díaz, Madrid, Spain., Hernández E; Nephrology Department, Hospital 12 de Octubre, Madrid, Spain., Martínez MI; Nephrology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain., Stanescu RI; Nephrology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain., Moirón JP; Nephrology Department, Clínica Universitaria de Navarra, Pamplona, Spain., García N; Nephrology Department, Clínica Universitaria de Navarra, Pamplona, Spain., Goicoechea M; Nephrology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain., Calero F; Nephrology Department, Fundació Puigvert, Barcelona, Spain., Bonet J; Nephrology Department, Hospital Germans Trias i Pujol, Badalona, Spain., Galceran JM; Nephrology Department, Fundació Althaia, Manresa, Spain., Liaño F; Nephrology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain., Pascual J; Nephrology Department, Hospital del Mar, Barcelona, Spain., Praga M; Nephrology Department, Hospital 12 de Octubre, Madrid, Spain., Fulladosa X; Nephrology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain; Spanish Group for the Study of Glomerular Diseases (GLOSEN), Grup de Treball de Malalties Glomerulars de la Societat Catalana de. Nefrologia (GlomCAT), and Grupo Español de Estudio de Nefropatía Diabética (GEENDIAB)., Soler MJ; Nephrology Department, Hospital del Mar, Barcelona, Spain.; Nephrology Department, Hospital Vall d'Hebron, Barcelona, Spain.
المصدر: Clinical kidney journal [Clin Kidney J] 2020 Jan 03; Vol. 13 (3), pp. 380-388. Date of Electronic Publication: 2020 Jan 03 (Print Publication: 2020).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Oxford University Press Country of Publication: England NLM ID: 101579321 Publication Model: eCollection Cited Medium: Print ISSN: 2048-8505 (Print) Linking ISSN: 20488505 NLM ISO Abbreviation: Clin Kidney J Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Oxford : Oxford University Press
مستخلص: 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 61.7 ± 12.8 years, creatinine was 2.8 ± 2.2 mg/dL and proteinuria 2.7 (interquartile range: 1.2-5.4) g/24 h. 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 < 0.001], microhaematuria (OR = 1.51, 95% CI: 1.03-2.21, P = 0.033) and absence of diabetic retinopathy (DR) (OR = 0.28, 95% CI: 0.19-0.42, P < 0.001) were independently associated with NDRD. Kaplan-Meier analysis showed that patients with DN or mixed forms presented worse renal prognosis than NDRD (P < 0.001) and higher mortality (P = 0.029). In multivariate Cox analyses, older age (P < 0.001), higher serum creatinine (P < 0.001), higher proteinuria (P < 0.001), DR (P = 0.007) and DN (P < 0.001) were independent risk factors for renal replacement therapy. In addition, older age (P < 0.001), peripheral vascular disease (P = 0.002), higher creatinine (P = 0.01) and DN (P = 0.015) were independent risk factors for mortality.
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.
(© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.)
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فهرسة مساهمة: Keywords: chronic kidney disease; diabetes mellitus; diabetic nephropathy; non-diabetic renal disease; renal biopsy
تواريخ الأحداث: Date Created: 20200724 Latest Revision: 20220415
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC7367112
DOI: 10.1093/ckj/sfz177
PMID: 32699618
قاعدة البيانات: MEDLINE
الوصف
تدمد:2048-8505
DOI:10.1093/ckj/sfz177