A Study Of Clinic Pathological In Diabetes Associated With Chronic Kidney Disease

Objective:To analyze the risk factors of Diabetic Nephropathy(DN)and the diagnostic value of the relationship of renal biopsy and diabetes mellitus associated with chronic kidney disease(CKD),by analyzing the renal pathology type of one hundred diabetics.Methods:By examining renal biopsy of one hundred diabetics who were the patients in the First Affiliated Hospital of Guangxi Medical University during December 2004 and December 2014,that suit for the diabetes diagnosis standard of world health organization(WHO)in 1999.Dividing the patients into two group with the results of renal pathology:diabetes nephropathy,DN(n1=33)and Non-diabetic renal disease,NDRD(n2=67),and comparing the difference in general clinical data,laboratory and pathology.Results:1.Comparison of general data from two groups,the age,proportion of male and female,body mass index,merger cases coronary heart disease,diastolic blood pressure was no significant difference compare different;the duration of diabetes in group DN is longer than group NDRD(P=0.000),the systolic blood pressure in group DN is higher than group NDRN(P= 0.006).2.The proportion of merger of proteinuria in group DN is more than group NDRD(P=0.000),the quantity of 24-hour urinary protein in group DN is higher than group NDRD(P=0.020),the proportion of combined a large amount of proteinuria in group DN is more than group NDRD(P=0.018),and the serum creatinine in group DN is more than group NDRD(P=0.007).3.The proportion of peripheral neuropathy diabetes mellitus no difference between the two groups was statistically significant,DN are combined and higher than the proportion of diabetic retinopathy NDRD group(P = 0.000).4.Diabetes duration,systolic blood pressure,diabetes retinopathy is an independent risk factor for diabetic nephropathy.5.DN group is given priority to with diffuse glomerular sclerosis type,pathological type NDRD group pathological type is given priority to with primary glomerular disease(mainly membranous nephropathy,IgA nephropathy).6.Two groups of patients with light microscope examination,renal puncture the glomerular number,there was no statistically significant difference glomerular sclerosis of segmental ratio,DN glomerular sclerosis of ball ratio greater than NDRD group(P = 0.000),mesangial cell proliferation degree is more important than NDRD group(P = 0.000),renal tubule and interstitial lesions range greater than NDRD group(P = 0.000),renal interstitial inflammatory cell infiltration heavier than NDRD group(P = 0.010),the proportion of small vascular lesions than NDRD group(P = 0.000).Conclusion:1.In group DN,the duration of diabetes is longer,the degree of merger of proteinuria is higher,and the proportion of combined diabetic retinopathy is more than group NDRD.2.the duration of diabetes,systolic pressure and combined diabetic retinopathy is the independent risk factor of Diabetic Nephropathy(DN).3.Renal biopsy pathologic examination is the main method to identify DN and NDRD,particularly for the patients who got short duration of diabetes,and the patients who with proteinuria without diabetic retinopathy.