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Clinical characteristics of diabetic nephropathy in patients with type 2 diabetic mellitus manifesting heavy proteinuria: A retrospective analysis of 220 cases

  • Author Footnotes
    1 First author: Xiaoyi Wang and Jie Li are co-first author.
    Xiaoyi Wang
    Footnotes
    1 First author: Xiaoyi Wang and Jie Li are co-first author.
    Affiliations
    Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China

    Department of Nephrology, The First Affiliated Hospital of Huzhou Teachers College, The First People's Hospital of Huzhou, Zhejiang Province 313000, China
    Search for articles by this author
  • Author Footnotes
    1 First author: Xiaoyi Wang and Jie Li are co-first author.
    Jie Li
    Footnotes
    1 First author: Xiaoyi Wang and Jie Li are co-first author.
    Affiliations
    Department of Nephrology, Lishui Central Hospital, Zhejiang Province 323000, China
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  • Lixia Huo
    Affiliations
    Department of Central Laboratory, The First Affiliated Hospital of Huzhou Teachers College, The First People's Hospital of Huzhou, Zhejiang Province 313000, China
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  • Yuehua Feng
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Huzhou Teachers College, The First People's Hospital of Huzhou, Zhejiang Province 313000, China
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  • Lingyan Ren
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Huzhou Teachers College, The First People's Hospital of Huzhou, Zhejiang Province 313000, China
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  • Xiner Yao
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Huzhou Teachers College, The First People's Hospital of Huzhou, Zhejiang Province 313000, China
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  • Hong Jiang
    Affiliations
    Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
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  • Rong Lv
    Affiliations
    Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
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  • Ming Zhu
    Correspondence
    Corresponding authors at: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University and Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou 313003, China (J. Chen).
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Huzhou Teachers College, The First People's Hospital of Huzhou, Zhejiang Province 313000, China
    Search for articles by this author
  • Jianghua Chen
    Correspondence
    Corresponding authors at: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University and Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou 313003, China (J. Chen).
    Affiliations
    Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
    Search for articles by this author
  • Author Footnotes
    1 First author: Xiaoyi Wang and Jie Li are co-first author.
Published:October 05, 2019DOI:https://doi.org/10.1016/j.diabres.2019.107874

      Abstract

      Aims

      To determine the predictability of diagnosing diabetic nephropathy (DN) versus non-diabetic renal disease (NDRD) from clinical and laboratory data in Chinese patients with type 2 diabetes mellitus (T2DM) manifesting heavy proteinuria.

      Methods

      We retrospectively analyzed the clinical and laboratory data of patients with T2DM manifesting heavy proteinuria who underwent renal biopsy from January 2014 to December 2017.

      Results

      According to renal biopsy, 220 patients were finally enrolled, including 109 cases diagnosed with DN alone (49.55%), 94 with NDRD alone (42.73%) and 17 with DN plus superimposed NDRD (7.73%). Multivariate analysis showed the significant risk factors for DN alone were age, duration of diabetes, presence of retinopathy, 24-h proteinuria, serum albumin and SBP. Presence of retinopathy achieved the highest overall diagnostic efficiency with the area under the curve of 0.852, sensitivity of 78.9% and specificity of 91.5%. The combined diagnosis with four indicators (duration of diabetes, retinopathy, SBP, and serum albumin) showed the area under the curve of 0.938, sensitivity of 88.1% and specificity of 87.2%.

      Conclusions

      The prevalence of DN is high in patients with T2DM manifesting heavy proteinuria. Renal biopsy should be performed in diabetics in the atypical clinical scenario.

      Keywords

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