Study On The Risk Factors Of The Progression In Type 2 Diabetic Nephropathy

Objective To explore the risk factors of progression in type 2 diabetic nephropathy.Methods Type 2 diabetes mellitus were collected from January 2015 to October 2017 who were hospitalized in the department of endocrinology or nephrology in the Lanzhou university second hospital.Combined with the exclusion criteria,a total of 2619 cases were included into statistical analysis.The patients were first grouped by their glomerular filtration rate(eGFR)to analyze the related factors for the progression of type 2 diabetic nephropathy.Then,the patients were grouped by the diabetic duration to explore the nature of the progression in type 2 diabetic nephropathy.Secondly,according to the 24-hour urinary protein level,the patients were divided into three groups: normal proteinuria,microalbuminuria,and clinical proteinuria.Then,the patients were grouped by the duration of diabetes mellitus combined with 24-hour urinary protein to investigate the risk factors for the development of proteinuria in type 2 diabetes mellitus.To investigate the correlation between clinical indicators and renal failure in patients with type 2 diabetes mellitus.Furthermore,use the ordinal logistic regression method to find out the independent risk factors for renal function progression in type 2 diabetic mellitus.Results The gender differences,age,duration of diabetes,hypertension,24-hour urinary protein,glycated hemoglobin,blood uric acid,cholesterol,and high-density lipoprotein,etc.all contribute to kidney damage in type 2 diabetes.But in the clinical,that truly reflect the progression of diabetic kidney disease in type 2 diabetes are 24 h urinary protein levels and proliferative diabetic retinopathy.Correlation analysis showed that kidney failure was positively correlated with age(r=0.11,P<0.01),24 h urinary protein(r=0.49,P<0.01),diabetes duration(r=0.28,P<0.01),systolic blood pressure(r=0.19,P<0.01),diastolic blood pressure(r=0.05,P<0.05),serum uric acid(r=0.30,P<0.01),proliferative diabetic retinopathy(r=0.22,P<0.01).Glycated hemoglobin(r=-0.05,P<0.05),cholesterol(r=-0.09,P<0.01)and low-density lipoprotein(r=-0.12,P<0.01)were negatively correlated with kidney failure.The male patients,long course of diabetes duration,hypertension,hyperuricemia,high-grade 24-hour urinary protein and proliferative diabetic retinopathy were independent risk factors for the progression of type 2 diabetic nephropathy.[OR=2.35,95%CI(1.81,3.04),P<0.01;OR=1.10,95%CI(1.08,1.12),P<0.01;OR=1.56,95%CI(1.19,2.04),P<0.01;OR=1.00,95%CI(1.00,1.01),P<0.01;OR=1.84,95%CI(1.72,1.98),P<0.01;OR=1.74,95%CI(1.18,2.56),P<0.01]?Conclusion 24-hour urinary protein levels and proliferative diabetic retinopathy can predict the progression of type 2 diabetic nephropathy and they were independent risk factors for the progression of diabetic nephropathy.