Clinical Analysis Of The Risk Factors For Diabetic Nephropathy

Objectives To analyze Type2diabetes mellitus (T2DM) patients with stages of diabetic nephropathy (DN) of the risk factors that can be used to explore the different stages of disease prediction and diagnosis of non-invasive clinical markers.Method Select the140cases with diabetic kidney disease (DKD) in Nephrology of the Lanzhou University Second Hospital in one year. Divided into two groups according to biopsy results, the first group is diabetic nephropathy (DN), all in116,male73and female43; the second group is non-diabetic nephropathy (NDN),all in24,12males and12females. All of the cases were recorded age, gender, measuring weight, height, blood pressure, body mass index, Detailed inquiry is now history, past history, surgery, trauma, allergies, etc.; detailed physical examination of the patient record abnormal signs; blood and urine tested indicators in accordance with the experimental procedure. All clinical and laboratory parameters will be collected for statistical analysis, analysis comparing actual results with clinical testing, explore its clinical practical significance.Results First, the two groups were compared for all selected objects:①clinical indicators:Compared with NDN patients, DN patients older (52.53±0.95, P=0.036), longer duration of diabetes (104.80±7.06, P=0.000), with the eyes of non-proliferative lesions (35.3%P=0.001), numbness and pain (31.9%, P=0.013), hypertension (85.3%, P=0.013), cataract (18.1%, P=0.014) and fatty liver (30.2%, P=0.019) in the a higher proportion of left ventricular diastolic function in patients prone to reduce (53.4%, P=0.000),and ST-T changes (31%,P=0.050).②laboratory parameters:Compared with NDN patients, DN patients blood urea nitrogen (BUN)(24.39±1.30, P=0.011), serum creatinine (Cr)(1.56±1.33, P=0.032), phosphorus (P)(1.31±0.03, P=0.018), urinary β2-microglobulin (β2MG)(5.51±0.63, P=0.015) were higher; glomerular filtration rate (GFR)(62.43±4.43, P=0.009), urinary osmolality (OSM)(533.75±19.9, P=0.044), fasting C peptide/postprandial2hC peptide (F-CP/2h-CP)(0.93±0.11, P=0.002) indicators were lower.③fasting C peptide/postprandial2hC peptide (OR=0.151, P=0.010), left ventricular diastolic function reduce (OR=31.307, P=0.010), urinary β2-microglobulin (OR=3.825, P=0.007), duration of diabetes (OR=1.016, P=0.021) were associated with DN as risk factors.④pathology manifestations in patients with DN:mesangial proliferative glomerular lesions and nodular lesions more common (88.79%); pathological manifestations in patients with NDN:mesangial proliferative disease, mesangial lesions with FSGS like lesions more common (79.17%).Second,the two groups were compared for all selected objects:①clinical indicators:DN patients compared with early NDN patients,with longer duration of diabetes (111.88±9.21, P=0.000), the eyes of non-proliferative lesions (35.1%, P=0.018), numbness and pain (31.1%, P=0.038), a higher proportion of cataract (24.3%, P=0.039), fatty liver (30.2%, P=0.019) and left ventricular diastolic function prone to reduce (58.1%, P=0.000), autonomic nerve impairment (21.6%, P=0.012), and ST-T changes (39.2%, P=0.027);②laboratory parameters:DN early patients compared with NDN patients:blood urea nitrogen (BUN)(25.21±1.74, P=0.030), phosphorus (P)(1.28±0.04, P=0.009), urinary β2micro-globulin ((32MG)(4.95±0.74, P=0.013) were higher; glomerular filtration rate (GFR)(69.84±4.37, P=0.009), fasting plasma free insulin/postprandial (FINS/2h-INS)(14.55±1.23, P=0.042), fasting C peptide/postprandial2hC peptide (F-CP/2h-CP)(0.70±0.06, P=0.001) indicators were lower;③left ventricular diastolic function reduce (OR=9.057, P=0.003), duration of diabetes (OR=1.015, P=0.011)were risk factors associated with DN.④pathology manifestations in patients with early DN:mesangial proliferative glomerular lesions and nodular lesions more common (94.60%); pathological manifestations in patients with early NDN:mesangial proliferative disease, glomerular membrane FSGS lesions and lesions more common (76.19%).Conclusion1.older, longer duration of diabetes, history of hypertension, retinal nonproliferative lesions, cataracts, fatty liver, numbness, pain, heart attack (reducing left ventricular diastolic function, ST-T change) and blood urea nitrogen, creatinine, phosphorus, increased urinary β2-microglobulin levels higher, Glomerular filtration rate, urine osmolality, fasting C peptide/peptide postprandial2hC index lower, these abnormalities were highly suggestive of type2diabetic patients suffering fromDN.2.1onger duration of diabetes, with the eyes of non-proliferative lesions, numbness, pain, cataracts, a high proportion of fatty liver, blood urea nitrogen, phosphorus, urine β2microglobulin higher glomerular filtration rate, fasting insulin free/postprandial and fasting C peptide/peptide index lower postprandial2hC, these abnormalities may contribute to type2diabetes patients with early diagnosis of DN. Reduce left ventricular diastolic function, duration of diabetes is also a risk factor for early DN.