Rational Analysis Of Diagnosis And Treatment Of Hospitalized Patients With Diabetic Kidney Disease

Diabetes Mellitus(DM)is a group of metabolic diseases characterized by chronic hyperglycemia,which is caused by insulin secretion shortage and(or)deficiency.In recent years,affected by the improving quality of life,lifestyle changes,aging population and increasing rates of obesity et al,the number of diabetic patients in the world is growing at a rapid pace.The global diabetes patients' number had reached about 382 million according to the International Diabetes Federation(IDF)statistics in 2013.The situation of diabetes in China is not optimistic.According to the 2010 China chronic disease surveillance and diabetes survey results,China's adult diabetes prevalence rate was 11.6%,in addition,the early stage of diabetes prevalence rate was 50.1%.Most patients will result in macrovascular complications(Hypertension,coronary heart disease)or/and microvascular complications(diabetic kidney disease,diabetic peripheral neuropathy)with the progressing of the disease.Diabetic Kidney Disease is one of the major microvascular complications of diabetes mellitus.It has been the leading cause of chronic kidney disease(CKD)in developed countries.In China,Diabetic Kidney Disease is also an important cause of CKD after glomerular nephritis.According to the reports in the literature in 2009-2013,the prevalence of type 2 diabetes patients with DKD in our community was 10-40% [1-2].Because of lacking national DKD epidemiological data,the unclear criterion and the different understanding of the disease,DKD was diagnosed blindly and imperfectly.It is well known that different renal diseases need different treatment,so it is very important to establish a correct diagnose.According to the?Expert consensus on the clinical diagnosis of adult diabetic kidney disease in China?in 2015,we investigate the rationality of diagnosis and treatment of hospitalized patients with diabetic kidney disease.Objective To investigate the rationality of diagnosis and treatment of diabetic kidney disease in the 202 Hospital of PLA.Methods 344 patients with type 2 diabetes mellitus were enrolled.Gather the relevant clinical data,include the patient's name,gender,age,diabetes duration,fasting and postprandial 2 hour blood glucose,BP,BMI,diabetic retinopathy,urine albumin and urine ACR(urinary albumin-to-creatinine ratio ACR)and clinical proteinuria,creatinine,blood urea nitrogen,SCys C,e GFR,TG,LDL-C and the use of hypoglycemic drugs,antihypertensive drugs and Lipid regulating drugs.Then,we analysized the rationality of diagnosis and treatment of hospitalized patients with diabetic kidney disease according to ?Expert consensus on the clinical diagnosis of adult diabetic kidney disease in China?in 2015 and?Expert consensus on prevention and treatment of diabetic nephropathy?in 2014.Results The usage rate of AGI was 58.7%,taking the first place in the non-insulin hypoglycemic agents.50% patients used or combined ACEI/ARB to delay the progression of renal function.100% patients used statins lipid regulating drugs according to the guidelines,but 28.6%patients use fibrates according to the guidelines only.Conclusion In the diagnosis of diabetic kidney disease,there are many cases should be excluded.There is no error in the use of hypoglycemic agents,but the use of antihypertensive drugs is not in conformity with the guidelines,in addition,the treatment for regulation of triglyceride is easy to be ignored.