Discussiom On The Progression Of Diabetic Nephroparhy

Objective: To probe into the factors affecting the length of timeduring which the condition of patients with established diabeticnephropathy and heavy proteinuria develop into the dialysis stage.Methods: we analyzed the data deprived from84in-patients withestablished diabetic nephropathy and heavy proteinuria and52patientsdiagnosed with chronic glomerulonephritis as a contrast. we respectivelyrecorded and measured the age, atherosclerotic index (ASI), anklebrachial index (ABI), brachial ankle pulse wave velocity (baPWV),24-hour ambulatory blood pressure value,24-hour urine protein, serumcreatinie (SCr), blood urea nitrogen (BUN), serum albumin (Alb), serumuric acid(SUA), glomerular filtration rate (GFR), fasting bloodglucose(FBG), triglyceride(Tg), total cholesterol(TC), hemoglobin(Hb),glycosylated hemoglobin(HbA1c) of patients when they had heavyproteinuria without abnormality of creatinine and when they began tohave dialysis. And the length of time from the discovering of heavyproteinuria to beginning of dialysis also was recorded.. Results:1. Compared with the control group, patients in the DNgroup had shorter length of time for them to develop into the dialysisstage.2. According to the data in the DN group, we found that the level ofASI, ABI on the left, baPWV, GFR, TC, TG, SUA,24-hour urine protein,SCr, Hb, SBP and HbA1c of patients they had heavy proteinuria withoutabnormality of creatinine and the level of ASI, baPWV, GFR, TC, TG,SUA, SCr, Hb, Alb, FBG and HbA1c of patients when they began to havedialysis for treatment had close connection with the length of timepatients developing into the dialysis stage.3. Compared with the control group, the level of DN group ASI, ABIon the left, TG, SUA, Hb, sBP measured when DN patients were onlywith heavy proteinuria and ASI, SUA,24-hour urine protein, SCrmeasured when DN patients began to have dialysis and the difference ofbaPWV on the left, TG, SUA, SCr, Hb, dBP between the two measuringpoint in time had greater correlation with the length of time patientsdeveloping into the dialysis stage.4. Through multiple linear regression analysis, the results comingfrom the DN group showed that the level of ASI, ABI on the left,baPWV, GFR, TC, BUN, Hb, sBP, dBP, FBG measured at the time ofheavy protein discovery and the level of baPWV, TG,24-hour urineprotein, FBG measured at the time of dialysis beginning and thedifference of ASI, ABI on the right, TG, SUA, BUN,24-hour urine protein, SCr, Alb, HbA1c between the two measuring point were the maininfluence factors of the length of time patients developing into thedialysis stage.Conclusions:1. DN patients consume shorter time from the discovery ofheavy protenuria to the dialysis stage compared with chronicglomerulonephritis.2. The early blood pressure presented in DN patients with heavyproteinuria is the influence factors of the progression of DN.3. Serum cholesterol of DN patients is an important factor for DNrapid progress.4. Nutritional status of patients with DN, including serum albuminand hemoglobin, are the factors which influence the progression of DN.5. Uric acid is the influential factor for DN progress during thecourse of DN.6. The change of ASI and ABI can reflect the degree of renalfunction impairment of DN patients.7. A variety of factors lead to the rapid progress of disease in DNpatients with heavy proteinuria.