Renal Division, Molecular Cell Lab for Kidney Disease, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630 Dongfang Road, Shanghai 200127, PR China.
Diabetes Res Clin Pract. 2010 Mar;87(3):354-9. doi: 10.1016/j.diabres.2009.11.012. Epub 2009 Dec 14.
It is important to differentiate proteinuria from non-diabetic renal diseases (NDRD) or diabetic nephropathy in diabetic patients. The purpose of our study was to evaluate the prevalence of NDRD. A retrospective analysis was performed on diabetic patients who had undergone renal biopsy during a 6-year period. Our study revealed a high prevalence of NDRD in the diabetic population. Sixty-nine patients were investigated, 52.2% were diagnosed as NDRD and 47.8% as DN. Focal segmental glomerulosclerosis was the most common lesion found in patients with NDRD. We found a relationship between DN and fasting blood glucose level, systolic blood pressure, diastolic blood pressure, LVMI, intima-media thickening (IMT), and the presence of carotid plaques. Patients with NDRD had a lower incidence of diabetic retinopathy (DR). The absence of DR to differentiate NDRD had a sensitivity of 72.7%, a specificity 91.7%, and an ROC=0.822. Fasting blood glucose level had a sensitivity and specificity of 93.9% and 75%, respectively. Similarly, the use of IMT had sensitivity and specificity of 90% and 75.8%, respectively. In this study, we determined that the absence of DR, a lower fasting blood glucose level, and IMT is useful in differentiating NDRD from DN in diabetic patients with overt proteinuria.
在糖尿病患者中，将蛋白尿与非糖尿病性肾脏疾病（NDRD）或糖尿病肾病区分开来非常重要。我们的研究目的是评估 NDRD 的患病率。对 6 年内接受过肾活检的糖尿病患者进行了回顾性分析。我们的研究显示，糖尿病患者中 NDRD 的患病率很高。调查了 69 名患者，52.2%被诊断为 NDRD，47.8%为 DN。局灶节段性肾小球硬化是 NDRD 患者最常见的病变。我们发现 DN 与空腹血糖水平、收缩压、舒张压、LVMI、内膜-中层厚度（IMT）和颈动脉斑块的存在之间存在关系。NDRD 患者发生糖尿病视网膜病变（DR）的几率较低。DR 不存在可以区分 NDRD 的敏感性为 72.7%，特异性为 91.7%，ROC=0.822。空腹血糖水平的敏感性和特异性分别为 93.9%和 75%。同样，IMT 的使用具有 90%和 75.8%的敏感性和特异性。在这项研究中，我们确定在显性蛋白尿的糖尿病患者中，DR 不存在、空腹血糖水平较低和 IMT 有助于将 NDRD 与 DN 区分开来。
