Correlation Analysis Between Renal Pathology And Clinical Features Of 121 Diabetic Nephropathy Patients

Objective: To analyze the correlation between the pathology and clinical characteristics of type 2 diabetic nephropathy(T2DN)and provide clinical evidence for the treatment and prognosis judgement of T2 DN.Methods: From January 2010 to December 2016,a total of 121 patients with T2 DN diagnosed by renal biopsy in the first affiliated hospital of China Medical University were enrolled in the study.The pathological classification and IFTA score were evaluated by the latest criteria for diabetic nephropathy proposed by Tervaet et al.in 2010.General clinical data of patients,including gender,age,diabetes course,glycated hemoglobin,serum lipids,serum albumin(Alb),hemoglobin(Hb),smoking and alcoholism history;Microvascular complications,including whether combined diabetic retinopathy(DR)and diabetic peripheral neuropathy(DPN);Clinical kidney damage indexes,including the estimated glomerular filtration rate(eGFR),Serum creatinine(Scr),cystain C,blood urea nitrogen(BUN),24 h urine protein,urine ?1 microglobulin,urine microalbumin,urine protein IgG were collected.To compare the differences of clinical manifestations between different pathological groups and the correlation between pathological changes and clinical manifestations.Results: 1.The difference of clinical characteristics between different glomerular pathological types were suggested: There was a significant decrease in eGFR in type III and type ? patients,especially for type ? patients,the eGFR significantly lower than the other three types.The Hb in type III and type ? patients,most of whom were in anemia,are significantly lower than type IIa and type IIb.The urine protein IgG of type III and type IV is significantly higher than type IIa and type IIb.The urine ?1 microglobulin and urine microalbumin of type III and type IV is significantly higher than type IIa.The rise of urine protein IgG is more pronounced.2.The correlation analysis between glomerular pathological classification and clinical manifestations indicates: the pathological classification of diabetic nephropathy is positively correlated with diabetes duration,Scr,BUN,cystain C,urinary protein excretion,the occurrence of hypertension and DR,negatively correlated with and eGFR,Hb,Alb and triglyceride.The results of the ordinal regression analysis indicates that the glomerular pathological classification of T2 DN is related to the DR and Hb independently.3.The correlation analysis between IFTA and clinical manifestations suggests that IFTA was positively correlated with Scr,BUN,cystatin C,urinary protein excretion,hypertension and DR,negatively correlated with eGFR,Hb,Alb and glycated hemoglobin.The ordinal regression analysis suggested that IFTA was independently related to Hb and Scr.Conduction: 1.When the glomerular pathological classification of patients reached type ?,the clinical manifestations aggravated obviously,In most patients,eGFR decreased and anemia occurred.Urine ? 1 microglobulin,urine microalbumin,especially urine protein IgG also increased significantly.2.The occurrence of hypertension and DR,the longer the course of diabetes,the higher the level of Scr,BUN,cystatin C and urine protein excretion,and the lower the level of eGFR,Alb and Hb,the heavier the pathological changes of the glomerulus.Among them,Hb and DR have a stronger indication of glomerular pathological changes.3.The presence of hypertension and DR,the higher the level of Scr,BUN,cystatin C and urine protein excretion,the lower the level of eGFR,Alb and Hb,the higher the level of IFTA.Among them,Hb and Scr have stronger prompt effect on IFTA.