Correlation Of Body Mass Index To Clinical Features And Outcome In The Middle-aged And Elderly Patients With Diabetic Kidney Disease

Objective In this study,the middle-aged and elderly patients with diabetic kidney disease(DKD)were enrolled.The relationship between body mass index(BMI)and clinical manifestations of DKD patients,as well as the renal outcome of DKD patients with different BMI levels were analyzed in detail.In order to provide a new theoretical basis for understanding the clinical characteristics and renal prognosis of patients with DKD.Methods We selected the patients aged?45 years with DKD in our hospital from July 2013 to June 2017.The clinical data and laboratory test results were collected,with a BMI increase of 5 kg/m2 as the discrimination degree,the patients with BMI?22.5 kg/m2 as the Stage 1,and 22.6 kg/m2 to 27.5 kg/m2 as the Stage 2(control group),27.6 kg/m2 to 32.5 kg/m2 was Stage 3,?32.6 kg/m2 was Stage 4.We analyzed and compared the clinical data and laboratory test results of each group,and the correlation between BMI and renal prognosis was discussed.Results1.A total of 158 patients with DKD were enrolled in this study.The mean age was 53.8 ±7.0 years,including 107 males and 51 females.There were 35 patients in Stage 1,86 patients with Stage 2(control group),32 patients with Stage 3,and 5 patients with Stage 4,what's more,29(82.9%)patients in Stage 1 could diagnosis central obesity.2.The levels of 24-hour urine protein and total cholesterol of Stage 1 were higher than those of Stage 2(P<0.05),the levels of serum albumin and hemoglobin were significantly lower than those of Stage 2.There were no significant differences in age,serum creatinine,uric acid,globulin,triglyceride and glycated hemoglobin.3.The levels of triglyceride and hemoglobin were higher of the patients in Stage 3 than in Stage 2(P<0.05).There were no significant differences in age,24-hour urine protein quantitation,serum creatinine,uric acid,albumin,globulin,total cholesterol and glycosylated hemoglobin.4.Patients in Stage 4 had a lower baseline age and higher levels of serum creatinine,total cholesterol,triglyceride and mean arterial pressure than the patients in Stage 4.There were no differences in 24-hour urine protein quantitation,serum uric acid,albumin,globulin,hemoglobin and glycosylated hemoglobin.5.The median follow-up time was 14 months,and a total of 3 8 patients progressed to ESRD.The percentage of the patients progressed to ESRD in each group was 40.0%(Stage 1),18.6%(Stage 2),15.6%(Stage 3),and 60.0%(Stage 4),respectively.By Kaplan-Meier method,the prognosis of Stage 1 and Stage 4 was worse than that of Stage 2 and there was no difference in the prognosis between the Stage 3 and Stage 2.ConclusionBody mass index is closely related to the clinical condition and renal prognosis of the middle-aged and elderly patients with chronic kidney disease.Compared to the DKD patients with BMI between 22.6 kg/m2 and 27.5 kg/m2,the patients with BMI?22.5 kg/m2 and BMI?32.6 kg/m2 had a severe clinical condition and poor renal prognosis.The clinical condition and renal prognosis of the patients with BMI between 27.6 kg/m2 and 32.5 kg/m2 were not significantly different from those with BMI between 22.6 kg/m2 and 27.5 kg/m2.