[应用肾脏病饮食改良公式评估2型糖尿病患者的肾功能不全]

[Use of modification of diet in renal disease equation in estimating renal insufficiency in type 2 diabetes patients].

作者信息

Li Qing, Yang Ming, Bao Ya-qian, Yu Hao-yong, Li Ming, Zhou Jian, Jia Wei-Ping, Xiang Kun-san

机构信息

Department of Endocrinology and Metabolism, Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 Jul 22;88(28):1966-9.

PMID:19062736

Abstract

OBJECTIVE

To investigate the significance of use of modification of diet in renal disease (MDRD) equation in calculating glomerular filtration rate (GFR) so as to estimate the prevalence of "renal insufficiency" in type 2 diabetes patients.

METHODS

Serum creatinine (Scr) and 24h-urinary albumin excretion (24 h-UAE) were measured in 1576 hospitalized type 2 diabetes patients. MDRD equation was used to calculate the GFR (GFR(MDRD)). GFR(MDRD) < 60 ml/min per 1.73 m2 was defined as "renal insufficiency".

RESULTS

(1) Of the 1576 subjects, 908 (57.6%), 503 (31.9%), and 165 (10.5%) had GFR(MDRD) > or =90, 90-60, and <60 ml/min per 1.73 m2 respectively. The prevalence of "renal insufficiency" was increased with aging (P < 0.01). (2) The prevalence rates of "renal insufficiency" of the normo-, micro-, and macroalbuminuric groups were 4.8%, 14.4%, and 43.4% respectively, with significant differences among them (all P < 0.01). (3) Of the 165 subjects with "renal insufficiency", 21 (12.7%) had neither abnormal Scr nor abnormal albuminuria.

CONCLUSION

Able to discover renal insufficiency early, MDRD equation has important clinical significance in evaluating the progression of renal dysfunction in type 2 diabetes patients.

摘要

目的

探讨应用肾脏病饮食改良（MDRD）公式计算肾小球滤过率（GFR）以评估2型糖尿病患者“肾功能不全”患病率的意义。

方法

对1576例住院2型糖尿病患者测定血清肌酐（Scr）和24小时尿白蛋白排泄率（24 h-UAE），采用MDRD公式计算GFR（GFR(MDRD)），将GFR(MDRD)<60 ml/min per 1.73 m2定义为“肾功能不全”。

结果

（1）1576例患者中，GFR(MDRD)≥90、90~60、<60 ml/min per 1.73 m2者分别为908例（57.6%）、503例（31.9%）和165例（10.5%）。“肾功能不全”患病率随年龄增加而升高（P<0.01）。（2）正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组“肾功能不全”患病率分别为4.8%、14.4%和43.4%，差异有统计学意义（均P<0.01）。（3）165例“肾功能不全”患者中，21例（12.7%）Scr和白蛋白尿均正常。