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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Article info
Publication history
Published online: October 05, 2019
Accepted:
September 30,
2019
Received in revised form:
September 18,
2019
Received:
June 27,
2019
Identification
Copyright
© 2019 Published by Elsevier B.V.
