Characterizing predictors of non-diabetic kidney disease (NDKD) in diabetic patients

Shadab, Sana; Mittal, Parmod; Barwad, Adarsh; Singh, Geetika; Subbiah, A.; Yadav, Rohitash; Mahajan, Sandeep; Bhowmik, Dipankar; Dinda, Amit Kumar; Agarwal, Sanjay Kumar; Bagchi, Soumita

doi:10.1007/s11255-021-02998-1

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…Both male and female genders have been demonstrated to be predictors of NDNP in the literature [23,24]. In our study, more male dominance was found in the DNP group and female gender was found to be a risk factor for NDNP.…”

Section: Discussionsupporting

confidence: 64%

Non-diabetic nephropathy in diabetic patients: incidence, HbA1c variability and other predictive factors, and implications

Demirelli,

Boztepe,

Şenol

et al. 2024

Int Urol Nephrol

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Purpose: Diabetes Mellitus (DM) is the leading cause of chronic kidney disease (CKD) in the population. In patients with diabetes mellitus, the incidence of non-diabetic nephropathy (NDNP) has been estimated to range from 3% to 82.9%. Personal judgment is frequently employed while deciding whether or not to do a kidney biopsy on diabetic patients. NDNP alters the prognosis and course of treatment for people with DM. In our study, we examined the incidence of NDNP concurrent with the progression of diabetes mellitus, as well as the laboratory and clinical indicators that could be utilized to forecast it.Methods: A retrospective analysis of 76 diabetic patients who underwent KB was conducted. Based on the pathological diagnoses of these patients, they were categorized as DNP (diabetic nephropathy) or NDNP. The de nition of HbA1C variability was determined by calculating the mean HbA1C and the average value of the HbA1C measurements, as well as the standard deviation (SD) for each participant.Results: NDNP was detected in 50% of 76 patients. Among patients with NDNP, 36.8% had focal segmental glomerulosclerosis (FSGS), 23.6% had membranous glomerulonephritis, and 7.8% had IgA nephritis. The NDNP group exhibited signi cantly higher rates of female gender, absence of diabetic retinopathy, shorter time to diagnosis of diabetes mellitus, chronic kidney disease, and proteinuria, less intensive medication for diabetes mellitus, presence of hematuria and leukociduria, serological marker positivity, and non-HbA1C variability.Risk factors for predicting non-diabetic nephropathy, as determined by multivariate analysis, included female gender, the absence of diabetic retinopathy, non-HbA1c variability and a positive serological test. Conclusion:In this study, a signi cant number of diabetic patients with chronic kidney disease were diagnosed with NDNP. Identifying these patients allows for treatment of the speci c underlying disease.Factors such as the absence of DR, non-HbA1c variability, female gender, and serological test positivity can predict NDNP and guide the clinician's decision on kidney biopsy. Further prospective studies are warranted to validate the e cacy of potential predictive factors like HbA1c variability.

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Section: Discussionsupporting

confidence: 64%

Non-diabetic nephropathy in diabetic patients: incidence, HbA1c variability and other predictive factors, and implications

Demirelli,

Boztepe,

Şenol

et al. 2024

Int Urol Nephrol

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“…Our results found that 40.67% of biopsied T2DM patients were diagnosed with NDKD and the incidence of DN + NDKD was more than one-third (31.72%) of T2DM patients. Previous study showed that the prevalence of NDKD averaged 41.3% ( Zhang et al, 2022 ) and prevalence in the DN + NDKD group varied from 4.7% to 19.72% ( Fontana et al, 2021 ; Liu et al, 2016 ; Shadab et al, 2022 ). The above study demonstrates that a high proportion of T2DM patients with CKD still have NDKD, and that there is a great heterogeneity in the prevalence.…”

Section: Discussionmentioning

confidence: 94%

A retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney disease

He,

Deng,

Tian

et al. 2024

PeerJ

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Background Type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD) poses a serious health threat and becomes a new challenge. T2DM patients with CKD fall into three categories, diabetic nephropathy (DN), non-diabetic kidney disease (NDKD), and diabetic nephropathy plus non-diabetic kidney disease (DN + NDKD), according to kidney biopsy. The purpose of our study was to compare the clinical characteristics and kidney outcomes of DN, NDKD, and DN + NDKD patients. Methods Data on clinical characteristics, pathological findings, and prognosis were collected from June 2016 to July 2022 in patients with previously diagnosed T2DM and confirmed DN and or NDKD by kidney biopsy at Tongji Hospital in Wuhan, China. The endpoint was defined as kidney transplantation, dialysis, or a twofold increase in serum creatinine. Results In our 6-year retrospective cohort research, a total of 268 diabetic patients were admitted and categorized into three groups by kidney biopsy. The 268 patients were assigned to DN (n = 74), NDKD (n = 109), and DN + NDKD (n = 85) groups. The most frequent NDKD was membranous nephropathy (MN) (n = 45,41.28%). Hypertensive nephropathy was the most common subtype in the DN+NDKD group (n = 34,40%). A total of 34 patients (12.7%) reached the endpoint. The difference between the Kaplan-Meier survival curves of the DN, NDKD, and DN + NDKD groups was significant (p < 0.05). Multifactorial analysis showed that increased SBP [HR (95% CI): 1.018(1.002–1.035), p = 0.025], lower Hb [HR(95% CI): 0.979(0.961–0.997), p = 0.023], higher glycosylated hemoglobin [HR(95% CI): 1.338(1.080–1.658), p = 0.008] and reduced serum ALB [HR(95% CI): 0.952(0.910–0.996), p = 0.032] were risk factors for outcomes in the T2DM patients with CKD. Conclusions This research based on a Chinese cohort demonstrated that the risk of endpoint events differed among DN, NDKD, and DN+NDKD patients. In T2DM patients with CKD, DN patients displayed worse kidney prognosis than those with NDKD or DN + NDKD. Increased SBP, higher glycosylated hemoglobin, lower Hb, and decreased serum ALB may be correlated with adverse kidney outcomes in T2DM patients.

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“…In addition, the study object was not a renal pathological result, but a grouping of diabetes nephropathy and non-diabetes nephropathy based on proteinuria. In 321 cases of diabetes patients with renal biopsy, 179 patients were without DKD (55.8%), and membranous nephropathy was the most common non-diabetic renal disease in patients with diabetes [ 12 , 13 ]. Therefore, this study excluded patients with an albumin creatinine ratio (ACR) >1.0 g.…”

Section: Introductionmentioning

confidence: 99%

Influence of Insulin Resistance on Diabetes Nephropathy

Miao

2023

Med Sci Monit

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Background Patients with insulin-resistant diabetes have the highest risk of kidney disease. The triglyceride glucose (TyG) index is considered a reliable and simple marker of insulin resistance. We studied the relationship between the TyG index, diabetic kidney disease (DKD), and related metabolic disorders in patients with type 2 diabetes. Material/Methods This retrospective study included a consecutive case series from January 2021 to October 2022 in the Department of Endocrinology at Hebei Yiling Hospital. In total, 673 patients with type 2 diabetes met the inclusion criteria. The TyG index was calculated by napierian logarithmic (ln) (fasting triglyceride×fasting glucose /2). Patient demographic and clinical indicators were obtained from medical records, and statistical analysis was conducted using SPSS version 23. Results The TyG index was significantly related to metabolic indicators (low-density lipoprotein, high-density lipoprotein, alanine aminotransferase, plasma albumin, serum uric acid, triglyceride, and fasting glucose) and urine albumin ( P <0.01) but not with serum creatinine and estimated glomerular filtration rate. In multiple regression analysis, an increase in the TyG index was revealed to be an independent risk factor for DKD (OR: 1.699, P <0.001). Conclusions The TyG index was independently related to DKD and related metabolic disorders; therefore, the TyG index can be used as an early sensitive target for clinical guidance in the treatment of DKD with insulin resistance.

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Characterizing predictors of non-diabetic kidney disease (NDKD) in diabetic patients

Cited by 6 publications

References 21 publications

Non-diabetic nephropathy in diabetic patients: incidence, HbA1c variability and other predictive factors, and implications

Non-diabetic nephropathy in diabetic patients: incidence, HbA1c variability and other predictive factors, and implications

A retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney disease

Influence of Insulin Resistance on Diabetes Nephropathy

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