| BackgroundIncidences of diabetes mellitus（DM）have increased rapidly around the world because of changes in human environments,behaviors,and lifestyles[1–3].According to incomplete statistics,the number of diabetes patients have doubled in the past 30years.In 2010,about 285 million people suffered from diabetes,and the number of diabetics is expected to grow to 439 million by 2030,accounting for 7.7 percent of the world’s total population of 20 to 79 years old.Diabetes always merger of cardiovascular and cerebrovascular diseases,peripheral arterial disease,kidney disease and other complications,about half of the type 2 diabetes and a third of type 1diabetes will develop into chronic kidney disease（CKD）.CKD is also a public health problem.The prevalence is about 8-16%.Zhang Luxia et collected 47204 patients from 13 provinces,founding that the prevalence of chronic kidney disease is10.8%.The number of all Chinese patients with chronic kidney disease is about 119.5million.The survey found that about 21.3 percent diabetes patients will combine chronic kidney disease.The number of DM with CKD is estimated to be 24.3 million in 2013.Complications of CKD include dyslipidemia,hyperkalemia,metabolic acidosis,anemia,bone mineral metabolism disorders and secondary parathyroid function,those will increase in all-cause mortality and cardiovascular mortality.When DM is combined with CKD,its clinical manifestations are complicated and diverse,which will bring difficulties in the diagnosis and treatment of diseases.Analysis the clinical features,kidney pathological characteristics and drug usage of the patients with CKD and DM compared to patients with CKD alone and explore the related factors to provide clinicians with more data.ObjectivesAnalysis the clinical features,kidney pathological characteristics and drug usage of the patients with CKD and DM compared to patients with CKD alone and explore the related factors.MethodsA total of 3499 pre-dialysis CKD patients across China were enrolled in the study between November 2011 and April 2016,taken from the Chinese Cohort Study of Chronic Kidney Disease.Patients with CKD and DM were defined as the CKD with DM group,and those with CKD and without DM were the CKD without DM group.Demographic,clinical,and laboratory data,concomitant medication,and renal pathological characteristics were collected and analyzed in this cross-sectional study.ResultsPatients in the CKD with DM group were older,had a higher male-to-female ratio,and were more likely to develop hypertension,hyperlipidemia,and other complications compared with the CKD without DM group.Age,smoking,and24-hurinary protein were associated with the prevalence of CKD with DM.In these two groups of patients,except for antihypertensive drugs,antilipemic,cardiovascular and cerebrovascular,and antianemic drugs were used at rates below 50%,with antianemic drug application being inadequate.A mere 18.38%of patients with CKD with DM had undergone a renal biopsy and only35.4%of them were confirmed to have diabetic nephropathy.Conclusions.Demographic and clinical traits of CKD patients with DM in China are problematic.The importance of a renal biopsy for patients with CKD with DM needs to be emphasized.Inadequate medication requires increased attention in the treatment of CKD patients with DM. |
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