Clinical Predictors of Nondiabetic Kidney Disease in Patients with Diabetes: A Single-Center Study
Background. Although diabetic kidney disease (DKD) could affect up to one-third of patients with diabetes mellitus (DM), these patients can develop kidney diseases different from DKD, or these conditions can superimpose on DKD. Several potential predictors of nondiabetic kidney disease (NDKD) have b...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2021/9999621 |
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| author | Francesco Fontana Rossella Perrone Francesco Giaroni Gaetano Alfano Silvia Giovanella Giulia Ligabue Riccardo Magistroni Gianni Cappelli |
| author_facet | Francesco Fontana Rossella Perrone Francesco Giaroni Gaetano Alfano Silvia Giovanella Giulia Ligabue Riccardo Magistroni Gianni Cappelli |
| author_sort | Francesco Fontana |
| collection | DOAJ |
| description | Background. Although diabetic kidney disease (DKD) could affect up to one-third of patients with diabetes mellitus (DM), these patients can develop kidney diseases different from DKD, or these conditions can superimpose on DKD. Several potential predictors of nondiabetic kidney disease (NDKD) have been proposed, but there are no definitive indications available for kidney biopsy in diabetic patients. Methods. We designed a single-center, cross-sectional, and retrospective cohort study to identify clinical and laboratory factors associated with a diagnosis of NDKD after native kidney biopsy in diabetic patients and to investigate differences in time to end-stage kidney disease (ESKD) in patients with a diagnosis of DKD and NDKD. Results. Of 142 patients included in our analysis, 89 (62.68%) had a histopathological diagnosis of NDKD or mixed NDKD + DKD. Patients in the NDKD group had significantly lower HbA1C, lower prevalence of diabetic retinopathy (DR), and less severe proteinuria, and there was a lower proportion of patients with nephrotic syndrome; the DKD group had significantly lower proportion of patients with hematological conditions. In the multivariate binary logistic regression, only absence of DR and presence of a hematological condition significantly predicted NDKD after adjustment for age and sex. Time to ESKD was significantly higher in patients with NDKD or mixed forms than in those with DKD. Conclusions. After a careful selection, more than half of kidney biopsies performed in diabetic patients can identify NDKD (alone or with concomitant DKD). Absence of DR and coexistence of a hematological condition (especially MGUS) were strong predictors of NDKD in our cohort. |
| format | Article |
| id | doaj-art-0ad6d7912bbb4c62a3784d9e31e147de |
| institution | Kabale University |
| issn | 2090-214X 2090-2158 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-0ad6d7912bbb4c62a3784d9e31e147de2025-02-03T07:23:30ZengWileyInternational Journal of Nephrology2090-214X2090-21582021-01-01202110.1155/2021/99996219999621Clinical Predictors of Nondiabetic Kidney Disease in Patients with Diabetes: A Single-Center StudyFrancesco Fontana0Rossella Perrone1Francesco Giaroni2Gaetano Alfano3Silvia Giovanella4Giulia Ligabue5Riccardo Magistroni6Gianni Cappelli7Struttura Complessa di Nefrologia e Dialisi, Azienda Ospedaliero-Universitaria di Modena, Modena, ItalySurgical Medical and Dental Department of Morphological Sciences, University of Modena and Reggio Emilia, Modena, ItalySurgical Medical and Dental Department of Morphological Sciences, University of Modena and Reggio Emilia, Modena, ItalyStruttura Complessa di Nefrologia e Dialisi, Azienda Ospedaliero-Universitaria di Modena, Modena, ItalySurgical Medical and Dental Department of Morphological Sciences, University of Modena and Reggio Emilia, Modena, ItalySurgical Medical and Dental Department of Morphological Sciences, University of Modena and Reggio Emilia, Modena, ItalyStruttura Complessa di Nefrologia e Dialisi, Azienda Ospedaliero-Universitaria di Modena, Modena, ItalyStruttura Complessa di Nefrologia e Dialisi, Azienda Ospedaliero-Universitaria di Modena, Modena, ItalyBackground. Although diabetic kidney disease (DKD) could affect up to one-third of patients with diabetes mellitus (DM), these patients can develop kidney diseases different from DKD, or these conditions can superimpose on DKD. Several potential predictors of nondiabetic kidney disease (NDKD) have been proposed, but there are no definitive indications available for kidney biopsy in diabetic patients. Methods. We designed a single-center, cross-sectional, and retrospective cohort study to identify clinical and laboratory factors associated with a diagnosis of NDKD after native kidney biopsy in diabetic patients and to investigate differences in time to end-stage kidney disease (ESKD) in patients with a diagnosis of DKD and NDKD. Results. Of 142 patients included in our analysis, 89 (62.68%) had a histopathological diagnosis of NDKD or mixed NDKD + DKD. Patients in the NDKD group had significantly lower HbA1C, lower prevalence of diabetic retinopathy (DR), and less severe proteinuria, and there was a lower proportion of patients with nephrotic syndrome; the DKD group had significantly lower proportion of patients with hematological conditions. In the multivariate binary logistic regression, only absence of DR and presence of a hematological condition significantly predicted NDKD after adjustment for age and sex. Time to ESKD was significantly higher in patients with NDKD or mixed forms than in those with DKD. Conclusions. After a careful selection, more than half of kidney biopsies performed in diabetic patients can identify NDKD (alone or with concomitant DKD). Absence of DR and coexistence of a hematological condition (especially MGUS) were strong predictors of NDKD in our cohort.http://dx.doi.org/10.1155/2021/9999621 |
| spellingShingle | Francesco Fontana Rossella Perrone Francesco Giaroni Gaetano Alfano Silvia Giovanella Giulia Ligabue Riccardo Magistroni Gianni Cappelli Clinical Predictors of Nondiabetic Kidney Disease in Patients with Diabetes: A Single-Center Study International Journal of Nephrology |
| title | Clinical Predictors of Nondiabetic Kidney Disease in Patients with Diabetes: A Single-Center Study |
| title_full | Clinical Predictors of Nondiabetic Kidney Disease in Patients with Diabetes: A Single-Center Study |
| title_fullStr | Clinical Predictors of Nondiabetic Kidney Disease in Patients with Diabetes: A Single-Center Study |
| title_full_unstemmed | Clinical Predictors of Nondiabetic Kidney Disease in Patients with Diabetes: A Single-Center Study |
| title_short | Clinical Predictors of Nondiabetic Kidney Disease in Patients with Diabetes: A Single-Center Study |
| title_sort | clinical predictors of nondiabetic kidney disease in patients with diabetes a single center study |
| url | http://dx.doi.org/10.1155/2021/9999621 |
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