Association Between Renal Filtration Function Evaluated By Various Methods And Chronic Complications Of Type 2 Diabetes Mellitus

Objective:1. To analyze the diagnostic efficiency of CKD-EPIcr, CKD-EPIcys and CKD-EPIcr-cys equations, Using 99 m Tc-DTPA nephro-dynamic imaging GFR as gold standard.2. To analyze the association between renal filtration function evaluated by various methods and chronic complications of type 2 diabetes mellitus3. To compare the correlations between CKD which defined by various estimated GFR equations and chronic complications of type 2 diabetes mellitus.Methods:269 T2 DM patients without kidney history hospitalized during January 2012 to December 2014 were selected as study subjects. Clinical data and related materials included history, blood biochemical test result, m GFR measured by 99 m Tc-DTPA nephro-dynamic imaging. Calculate e GFR from different equations.1. To draw the ROC curve for CKD-EPIcr, CKD-EPIcys and CKD-EPIcr-cys equations by using 99 m Tc-DTPA nephro-dynamic imaging GFR as gold standard and m GFR<60ml/(min·1.73m2) as the diagnostic segmentation points.2. To define GFR≥60ml/(min·1.73m2) as normal GFR group and GFR<60ml/(min·1.73m2) as declined GFR group and analyze association between GFR and chronic complications of T2 DM.3. To compare the correlations between CKD which defined by various estimated GFR equations and chronic complications of type 2 diabetes mellitus.Results:1. The areas under the ROC curve of CKD-EPIcr, CKD-EPIcys and CKD-EPIcr-cys equations were0.873(0.825-0.921)、0.885(0.842-0.928)、0.899(0.858-0.940), respectively.After Z test for any two of the areas, there were no significantly difference(P?0.05).2. Compared with the normal GFR group, the patients in declined GFR group were older,having longer duration and higher systolic pressure(P<0.05). To history, the patients in declined GFR group had higher prevalence of CVD, HBP and CHD(P<0.05). To the blood biochemical test results,he patients in declined GFR group had higher level of Scr,Cys C, BUN, UA, UACR, lower level of LDL(P<0.05).3. CHD patients had lower m GFR and different e GFR than the non-CHD(P<0.05).Patients separately with CAS, DR, albuminuria, DPN and DF had lower m GFR compared to the control group.4. The patients in declined GFR group had significantly higher prevalence of CHD, CAS,DR, albuminuria, DPN and DF than patients in normal GFR group, respectively.5. CKD defined by m GFR and different e GFR independently correlated with CHD, the OR from large to small were CKD1 [2.77(1.40-5.47)], CKD2 [2.46(1.23-4.93)], CKD4[2.31(1.20-4.43)], CKD3 [2.22(1.16-4.24)]. CKD defined by m GFR and different e GFR independently correlated with albuminuria, the OR from large to small were CKD1[3.92(1.97-7.79)] 、 CKD4 [3.52(1.90-6.54)] 、 CKD3 [3.00(1.72-5.24)] 、 CKD2[2.93(1.47-5.85)]. CKD4 defined by e GFRcr-cys independently correlated with DPN and DF, the OR was 4.77(1.44-15.76),3.31(1.69-6.48), respectively, while the rest of CKD defined by other GFR did not associate with DNP and DF. CKD defined by m GFR and different e GFR did not associate with CAS and DR.Conclusion:1. CKD-EPIcr, CKD-EPIcys and CKD-EPIcr-cys equations had good diagnostic efficiency on CKD.2. Among the T2 DM patients, the one with CKD had higher prevalence of CHD, CAS,DR, albuminuria, DPN and DF.3. CKD is the independent risk factor of CHD and albuminuria. CKD defined by CKD-EPIcr equation had the strongest correlation with CHD.CKD defined by CKD-EPIcr-cys equation had the strongest correlation with albuminuria, and independently correlated with DPN and DF.