| Object:By collating clinical,laboratory and pathological data of diabetic kidney disease,analyzed its clinical characteristics,the relationship between clinical data and pathological classification and the correlation between clinical indicators and impairment of renal function retrospectively.Methods:1.This study collected 336 cases of type 2 diabetes patients with kidney disease confirmed by renal biopsy in nephrology department of second hospital of jilin university from January 2000 to August 2017.The selected subjects had complete clinical,laboratory and pathological data.Made the record of laboratory indexes such as gender,age,blood glucose,glycosylated hemoglobin,hemoglobin,serum creatinine,24 hours urinary protein quantification,calculated the glomerular filtration rate(GFR),made statistics of history of diabetes and kidney disease duration,the incidence of insulin treatment,diabetic retinopathy(DR),hypertension,nephrotic syndrome,renal failure,anemia incidence.And made statistics of the pathological types of renal diseases and their respective proportions.2.According to the pathological diagnosis these cases were divided into three groups which were diabetic nephropathy(DN)of 81 cases(24.11%),DN+NDRD group of,non-diabetic nephropathy(NDRD)of 187 cases(55.65%),non-diabetic and diabetic nephropathy(DN+NDRD)of 68 cases(20.24%).To analyze the relationship between the overall clinical and pathological data of patients with type 2 diabetes mellitus combined with kidney disease and the relationship of the clinical data of each pathological group.To explore the pathological stage(classification)of type 2 diabetes mellitus with non-diabetic nephropathy,the form of the pathological classification of clinical syndromes and the correlation between clinical and laboratory data and glomerular filtration rate.All data were statistically analyzed by using SPSS 17.0.Results:1.There were 336 selected cases,211 males and 125 females.The onset age was between 19 and 82 years old,with an average age of 51.15±11.85 years.The median history of diabetes was 3 months,the median history of kidney disease was 48.67 months,73.21% of the cases were clinically diagnosed as hypertension,and 66.96% of the patients received insulin treatment.There was no statistical difference in age and gender between the groups of DN,NDRD and DN+NDRD,the obesity index in DN+NDRD group was significantly higher than the DN.2.Clinical and laboratory data comparison in groups of T2 DM patients with renal biopsy: There were statistical differences between DN group and NDRD group in the history of diabetes,kidney disease,blood glucose,24 hours urinary protein quantification,eGFR,hemoglobin,blood albumin,incidence of hypertension,DR,nephrotic syndrome,anemia.There were statistical differences between DN group and DN+NDRD group in diabetes history,renal history,blood glucose,nephrotic syndrome incidence and anemia rate.There were statistical differences between DN group and DN+NDRD group in the diabetes history,24 hours urinary protein quantification,eGFR,hemoglobin,blood albumin,incidence of hypertension incidence,DR,nephrotic syndrome,anemia.3.In the pathological type distribution of NDRD and DN+NDRD group,in the mass,membranous nephropathy was the most common.In NDRD group,membranous nephropathy was the most common.In DN+NDRD group,it was hypertensive renal arterial sclerosis.There were statistical differences between the groups of NDRD and DN+NDRD in the distribution of IgA nephropathy and hypertensive renal arterial sclerosis.4.The analysis of stage of membranous nephropathy: In the group of NDRD stage of membranous nephropathy Ⅰ was most common,stage of membranous nephropathy Ⅰ-Ⅱ toke second place(P < 0.05);In the group of DN+NDRD,stage of membranous nephropathyⅠwas most common,stage of membranous nephropathy Ⅱ toke second place.5.The analysis of classification of IgA nephropathy: In the group of NDRD the level of Lee Ⅲ were most common,the level of LeeⅡtoke second place;In the group of DN+NDRD,the level of Lee Ⅳ was most common,the level of Lee Ⅱtoke second place.6.In group of NDRD,the most common pathological type which was manifested asrenal failure were sclerosing glomerulonephritis and crescent glomerulonephritis,the most common pathological type which was manifested as nephrotic syndrome,high blood pressure and hematuria was membranous nephropathy;In the DN+NDRD group,the most common pathological type which was manifested as nephrotic syndrome,renal failure,hypertension,and hematuria was hypertension renal arteriosclerosis.7.In the group of DN the eFFR was linear related with urine protein quantification,in the group of NDRD it was linear related with age,systolic blood pressure and in the group of DN+NDRD it was linear related with age,urine protein.Conclusion:1.Patients of type 2 diabetes mellitus with kidney disease under renal biopsy had short duration of diabetes,most of whom did not combined DR,and most of them combined hematuria.2.55.65% of type 2 diabetes with kidney disease under renal biopsy were NDRD,of which the most common pathological types was membranous nephropathy;with 10.34% of the whole patients were DN+NDRD,of which the most common pathological types was hypertension renal arteriosclerosis.3.Among the patients of type 2 diabetes mellitus with kidney disease under renal biopsy,there were statistical significances between diabetic nephropathy and non-diabetic nephropathy in the indicators of duration of diabetes,urinary protein quantification,the incidence of anemia,hypertension,hematuria,DR.4.Progress in renal function impairment of type 2 diabetes mellitus with kidney disease under renal biopsy were related to indicators of the age,urinary protein quantification,systolic blood pressure,duration of diabetes. |
