Renal pathological implications in type 2 diabetes mellitus patients with renal involvement
| Autor: | Xiuhui Zhang, Li Li, Lichuan Yang, Rongzheng Yue, Fang Liu, Songmin Huang, Qinghua Yin, Zhi-Cheng Li, Rui Zhang, Cijiang He, Baihai Su, Huan Xu, Ruikun Guo |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Biopsy Endocrinology Diabetes and Metabolism medicine.medical_treatment 030232 urology & nephrology Urology Renal function 030209 endocrinology & metabolism Kidney Kidney Function Tests urologic and male genital diseases Diabetic nephropathy 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Endocrinology Membranous nephropathy Risk Factors Internal Medicine Humans Medicine Diabetic Nephropathies Renal replacement therapy Renal Insufficiency Chronic Aged Retrospective Studies Creatinine Proteinuria medicine.diagnostic_test business.industry Type 2 Diabetes Mellitus Middle Aged medicine.disease Diabetes Mellitus Type 2 chemistry Female Renal biopsy medicine.symptom business |
| Zdroj: | Journal of Diabetes and its Complications. 31:114-121 |
| ISSN: | 1056-8727 |
| DOI: | 10.1016/j.jdiacomp.2016.10.024 |
| Popis: | Aims To investigate the renal pathological implications in type 2 diabetes mellitus patients with renal involvement. Methods A total of 328 type 2 diabetes mellitus (T2DM) patients with renal involvement who underwent a renal biopsy and received follow-up for at least one year were recruited in our study. The patients were divided into the diabetic nephropathy (DN), non-diabetic renal disease (NDRD), and NDRD superimposed on DN groups based on the pathological diagnosis. Renal outcomes were defined by the initiation of renal replacement therapy or doubling of the serum creatinine. Kaplan–Meier analysis was used to compare renal survival, and Cox proportional hazard analysis was used to determine the predictors of renal outcomes in the DN group. Results Renal biopsy findings revealed that 188 patients (57.32%) had pure DN, 121 patients (36.89%) had NDRD alone, and 19 patients (5.79%) had NDRD superimposed on DN. The most frequent subclassification of NDRD was membranous nephropathy (MN). Compared with the NDRD and NDRD superimposed on DN groups, patients with pure DN had poorer renal function and lower renal survival rates. In the DN group, the five-year renal survival rates of glomerular classes of I, IIa, IIb, III and IV were 100%, 84.62%, 60%, 47.5% and 33.33%, respectively. Multivariate Cox proportional hazard analysis showed that the glomerular lesions, proteinuria and serum creatinine were independent risk factors for renal outcomes, while interstitial fibrosis/inflammation and arteriolar hyalinosis were not independently associated with renal outcomes in the DN group. Conclusions Making an accurate pathologic diagnosis by renal biopsy is crucial for diabetes mellitus (DM) patients with renal involvement. The findings of our present study indicated that patients with pure DN had poorer renal outcomes than patients with NDRD or NDRD superimposed on DN. The classification of glomerular lesions, proteinuria and serum creatinine were independent risk factors for renal outcomes in the DN group. More studies with large samples and longer time follow-up are needed to evaluate the relationship between pathological changes and clinical characteristics in T2DM patients who have renal involvement. |
| Databáze: | OpenAIRE |
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