Correlation Analysis Of Clinical And Pathological Features In Patients With Type 2 Diabetes Mellitus With Kidney Disease

Objective:By analyzing the renal pathological types and distribution of patients with type 2 diabetes mellitus(T2DM)with renal disease,and comparing the clinical characteristics of diabetic nephropathy(DN)and non-diabetic nephropathy(NDRD),to find the clinical predictive indexes of T2 DM patients with NDRD,so as to provide reliable basis for determining the indication of renal biopsy.Method:A total of 158 T2 DM patients with renal diseases admitted in the Department of Nephrology,affiliated Hospital of Chengde Medical College from March 2011 to November 2020 were selected and divided into DN group,NDRD group and DN + NDRD group according to pathology.The clinical,pathological and laboratory data of the patients were collected,the related factors were analyzed by logistic regression,and the NDRD diagnosis model was established based on logistic regression.Results:1.The renal pathological results of 158 patients with renal biopsy showed that there were 41 cases of DN(25.9%),107 cases of NDRD(67.7%)and 10 cases of DN+ NDRD(6.3%).The most common pathological type of NDRD in NDRD and DN+NDRD groups was membranous nephropathy.2.Multivariate logistic retrospective analysis showed that diabetes duration(OR=0.990,95%CI=0.984-0.997),diabetic retinopathy(OR=0.226,95%CI=0.078-0.655),hemoglobin(OR=1.040,95%CI=1.010-1.070),e GFR(OR= 1.040,95%CI=1.016-1.066)and fasting blood glucose(OR=0.792,95%CI=0.661-0.948)were independent predictors of NDRD.3.Based on logistic regression analysis,the five predictive indexes of diabetes duration,diabetic retinopathy,hemoglobin,e GFR and fasting blood glucose were sorted into an equation,and a prediction model of NDRD was established.The area under the ROC curve of the model is 0.920 and has high sensitivity(84.6%)and specificity(90.2%),which can be helpful for the differential diagnosis of NDRD.Conclusion:1.There are various renal pathological types of NDRD in T2 DM patients with renal disease who received renal biopsy,and the most common type of NDRD is membranous nephropathy.2.Diabetes duration,diabetic retinopathy,hemoglobin,e GFR and fasting blood glucose are independent predictors of NDRD,but a single index is not effective in the diagnosis of NDRD.The establishment of a multi-factor combined prediction model can improve the diagnostic efficiency of NDRD and provide a basis for clinical differential diagnosis.