Clinical Characteristics Of Diabetes Combined With Non-diabetic Kidney Disease

Objective:The aim of this study was to evaluate the clinical characteristics and independent risk factors of diabetes mellitus(DM)with non-diabetic kidney disease(NDKD).Early identification of patients with diabetes mellitus complicated with NDKD is helpful for appropriate medical intervention treatment as soon as possible.Methods:From September 2014 to October 2018,63 patients with diabetes mellitus complicated with nephropathy admitted to the union hospital of Fujian Medical University for renal biopsy were selected for analysis according to inclusion criteria and exclusion criteria.According to the pathological results of renal puncture,the patients were divided into diabetic patients with diabetic nephropathy and diabetic patients with non-diabetic nephropathy.The clinical characteristics and laboratory data of the two groups were compared by t-test,chi-square test and Logistic regression.The prevalence rate,clinical characteristics and independent risk factors of NDKD in patients with type 2 diabetes undergoing renal biopsy were analyzed.Results:Among the 63 diabetic patients with nephropathy,the diabetic patients with non-diabetic kidney disease accounted for 42.86%(27/63),including 17 males(62.96%)and 10 females(37.04%)with an average age of 59.04±11.61 years.Membranous nephropathy was the most common pathological type in NDKD patients(66.67%).One-way ANOVA showed that there were significant differences in duration of diabetes,incidence of hypertension,systolic blood pressure,diastolic blood pressure,glycosylated hemoglobin,neutrophil/lymphocyte,hemoglobin and total cholesterol,triglyceride,low density lipoprotein,urea nitrogen,creatinine,serum uric acid,urinary microalbumin/serum creatinine ratio,glomerular filtration rate,diabetic retinopathy(DR),diabetic peripheral neuropathy(DPN),urinary erythrocyte between NDKD group and diabetic kidney disease(DKD)group(P<0.05).Multivariate Logistic regression analysis showed that diabetic retinopathy[OR,0.045,95%confidence interval(CI)0.003-0.581,P=0.018]was negatively correlated with the incidence of NDKD,triglyceride?1.86 mmol/L[OR,6.439,95%CI,1.568-26.441,P=0.010]and eGFR?60ml/min/1.73m~2[OR,9.405,95%CI,1.923-46.000,P=0.006]were positively correlated with the incidence of NDKD.Diabetic retinopathy is a protective factor for diabetic patients with NDKD,the absence of triglyceride?1.86 mmol/L and eGFR?60ml/min/1.73m~2 is considered to be an important and independent risk factor for diabetic patients with NDKD.Conclusion:1.Non-diabetic kidney disease(NDKD)is not rare in diabetic patients,the diabetic patients with non-diabetic kidney disease accounted for 42.86%in our study.2.The most common pathological type is membranous nephropathy in our study.3.There were significant differences in duration of diabetes,incidence of hypertension,systolic blood pressure,diastolic blood pressure,glycosylated hemoglobin,neutrophil/lymphocyte,hemoglobin and total cholesterol,triglyceride,low density lipoprotein,urea nitrogen,creatinine,serum uric acid,urinary microalbumin/serum creatinine ratio,glomerular filtration rate,diabetic retinopathy,diabetic peripheral neuropathy,urinary erythrocyte between NDKD group and diabetic kidney disease(DKD)group(P<0.05).4.The non-diabetic kidney disease group had less diabetic retinopathy,better renal function status and higher serum triglyceride level,which provided certain reference value for the diagnosis and treatment of such patients.