Miniatura

Fitxers

BermejoS.pdf (560.03 KB)

Tipus de document

Article

Versió

Versió publicada

Data de publicació

2020-06-01

Llicència de publicació

cc by-nc (c) Bermejo et al., 2020
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/171850

Risk factors for non-diabetic renal disease in diabetic patients

Títol de la revista

Autors

Director/Tutor

ISSN de la revista

Títol del volum

Recurs relacionat

https://doi.org/10.1093/ckj/sfz177

Resum

Background. Diabetic patients with kidney disease have a high prevalence of non-diabetic renal disease (NDRD). Renal and patient survival regarding the diagnosis of diabetic nephropathy (DN) or NDRD have not been widely studied. The aim of our study is to evaluate the prevalence of NDRD in patients with diabetes and to determine the capacity of clinical and analytical data in the prediction of NDRD. In addition, we will study renal and patient prognosis according to the renal biopsy findings in patients with diabetes. Methods. Retrospective multicentre observational study of renal biopsies performed in patients with diabetes from 2002 to 2014. Results. In total, 832 patients were included: 621 men (74.6%), mean age of 61.7612.8 years, creatinine was 2.862.2 mg/dL and proteinuria 2.7 (interquartile range: 1.2-5.4) g/24 h. About 39.5% (n = 329) of patients had DN, 49.6% (n = 413) NDRD and 10.8% (n = 90) mixed forms. The most frequent NDRD was nephroangiosclerosis (NAS) (n = 87, 9.3%). In the multivariate logistic regression analysis, older age [odds ratio (OR) = 1.03, 95% CI: 1.02-1.05, P< 0.001], microhaematuria (OR = 1.51, 95% CI: 1.03-2.21, P = 0.033) and absence of diabetic retinopathy (DR) (OR = 0.28, 95% CI: 0.19-0.42, P< 0.001) were independently associated with NDRD. Kaplan-Meier analysis showed that patients with DN or mixed forms presented worse renal prognosis than NDRD (P< 0.001) and higher mortality (P = 0.029). In multivariate Cox analyses, older age (P< 0.001), higher serum creatinine (P< 0.001), higher proteinuria (P< 0.001), DR (P = 0.007) and DN (P< 0.001) were independent risk factors for renal replacement therapy. In addition, older age (P< 0.001), peripheral vascular disease (P = 0.002), higher creatinine (P = 0.01) and DN (P = 0.015) were independent risk factors for mortality. Conclusions. The most frequent cause of NDRD is NAS. Elderly patients with microhaematuria and the absence of DR are the ones at risk for NDRD. Patients with DN presented worse renal prognosis and higher mortality than those with NDRD. These results suggest that in some patients with diabetes, kidney biopsy may be useful for an accurate renal diagnosis and subsequently treatment and prognosis.

Matèries

Diabetis, Insuficiència renal crònica

Matèries (anglès)

Diabetes, Chronic renal failure

Citació

Col·leccions

Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

BERMEJO, Sheila, GONZALEZ, Ester, LÓPEZ REVUELTA, Katia, IBERNÓN, Meritxell, LÓPEZ, Diana, MARTÍN GÓMEZ, Adoración, GARCÍA OSUNA, Rosa, LINARES, Tania, DÍAZ, Montserrat, MARTÍN, Nàdia, BARROS FREIRÍA, Xoana, MARCO, Helena, NAVARRO, Maruja isabel, ESPARZA, Noemí, ELIAS, Sandra, COLOMA, Ana, ROBLES, Nicolás roberto, AGRAZ, Irene, POCH, Esteban, RODAS, Lida m., LOZANO, Víctor, FERNÁNDEZ ALARCÓN, Beatriz, HERNANDEZ, Eduardo, MARTINEZ, Maria isabel, STANESCU, Ramona ionela, MOIRÓN, José pelayo, GARCÍA, Núria, GOICOECHEA, Marian, CALERO, Francesca, BONET, Josep, GALCERAN, Josep m., LIAÑO, Fernando, PASCUAL, Julio (pascual santos), PRAGA, Manuel, FULLADOSA, Xavier, SOLER, María josé. Risk factors for non-diabetic renal disease in diabetic patients. _Clinical Kidney Journal_. 2020. Vol. 13, núm. 3, pàgs. 380-388. [consulta: 31 de gener de 2026]. [Disponible a: https://hdl.handle.net/2445/171850]

Exportar metadades

JSON - METS

Compartir registre