Clinical And Pathological Analysis Of Type 2 Diabetes Mellitus Patients With Non-diabetic Kidney Disease

Objective:To explore the clinical and pathological characteristics of type 2 diabetes mellitus patients with non-diabetic kidney disease.Methods:Ninety patients with T2DM complicated with CKD who were treated at the China-Japan Union Hospital of Jilin University from January 2010 to August 2022 and diagnosed by renal puncture biopsy were included,including 54 males and 36 females.First,the pathological results of renal puncture were analyzed,and then two grouping methods were made according to the pathological types.The first grouping method included 90 patients,divided into a simple DKD group,simple NDKD group,and DKD combined with the NDKD group;Due to the large number of patients with IMN among the 90 patients,the second grouping method was adopted.A total of70 patients were included and divided into the DKD group,IMN group,and DKD with IMN group.Collect the general clinical data and laboratory indicators of patients,apply SPSS 25.0software,and pass the F test,H testX2Test,Bonferroni multiple comparison method,and other statistical analysis methods were used to make statistics on the relevant data and analyze the clinical predictors of T2DM patients with NDKD or IMN.The difference was statistically significant with P<0.05.Results:1.Among the 90 consecutive patients,67.8%(61/90)were patients with NDKD,of which MN accounted for 67.2%(41/61);At the same time,the detection rate of MN in the simple NDKD group and DKD combined with NDKD group is similar,accounting for 68%(34/50)and 63.6%(7/11)respectively,which is the most common renal pathological type of NDKD in this study.The second is Ig AN,accounting for 19.7%(12/61).The patients with NDKD were further grouped according to their age.The results showed that MN was the most common renal pathological type of NDKD in all age groups,accounting for 46.7%(7/15)in the youth group,85%(17/20)in the middle age group,and 68%(17/25)in the elderly group.2.Multiple comparisons were made on the unequal data in the simple DKD group,the simple NDKD group,and the DKD combined with the NDKD group.Compared with the simple DKD group,the simple NDKD group had a shorter course of diabetes and a higher level of triglycerides,with statistically significant differences(P<0.05).Compared with the DKD group or DKD combined with the NDKD group,the systolic blood pressure level in the NDKD group was lower,and the difference was statistically significant(P<0.05).Among 55 patients with early CKD(e GFR≥60 ml/min/1.73m~2),the hemoglobin count level in the NDKD group alone and DKD combined with NDKD group was higher than that in the DKD group alone(P<0.05).Among the54 patients with serum PLA2R antibody detection,the positive rate of antibody in the NDKD group alone and DKD combined with the NDKD group was higher than that in the DKD group alone(P<0.05),and the difference was statistically significant(P<0.05).In addition,all patients with serum PLA2R antibody positive had a pathological diagnosis of MN.Among the 62 patients who underwent fundus examination,the DR and PDR detection rate in the NDKD group was significantly lower than in the DKD group(P<0.05).3.Multiple comparisons were made on the unequal data in the simple DKD,the simple IMN,and the DKD+IMN groups.Compared with the simple DKD group,the simple IMN group had a shorter course of diabetes,a higher level of triglycerides,and a higher high-density lipoprotein count,all of which were statistically significant(P<0.05).Compared with the DKD group or DKD combined with the IMN group,the systolic blood pressure level in the IMN group was lower,and the difference was statistically significant(P<0.05).Conclusions:1.Among T2DM patients with CKD,NDKD patients account for a large proportion(67.2%),among which MN is the most common pathological type,followed by Ig AN.At the same time,MN has the highest proportion in all age groups.2.The duration of diabetes is shorter,the systolic blood pressure level is lower,the triglyceride level is higher,the serum PLA2R antibody is positive,there is no DR or PDR,and patients with early CKD(e GFR≥60 ml/min/1.73m~2)are accompanied by an increase in hemoglobin count,which can predict the occurrence of NDKD in T2DM patients.3.The duration of diabetes is shorter,the systolic blood pressure level is lower,the triglyceride level is higher,the high-density lipoprotein count is higher,and the serum PLA2R antibody is positive,which can predict the occurrence of T2DM patients with IMN.