University of Salamanca School of Medicine, Salamanca, Spain.
Eur J Intern Med. 2012 Apr;23(3):283-6. doi: 10.1016/j.ejim.2011.10.014. Epub 2011 Nov 21.
Diabetic nephropathy is a common cause of end stage renal disease. Notwithstanding, wide inter-individual variations in the speed of progression of diabetic nephropathy are frequent. We have used the score of the HUGE formula to predict progression of kidney disease in a group of diabetic nephropathy patients.
The sample consisted of 84 type 2 diabetic patients. At treatment entry, the mean age was 62.1 ± 12.5 years and 59.5% were male. Blood pressure was measured at office at each visit. Serum creatinine, urea, hematocrit and 24h proteinuria were analyzed every 6 months. HUGE score was calculated from gender, urea and hematocrit.
Mean HUGE score was 0.99 ± 3.88. Using as cut off point 1.5, those patients who had a score equal or higher (n=31) showed a bigger increase in serum creatinine after one year (41.8 ± 62.1%) than those subjects with score<1.5 (n=53) (18.7 ± 38.6%, p=0.041). 5 patients with low HUGE score reached end stage renal failure (9.4%) and 10 patients in the high HUGE score group (32.3, p=0.008). When logistic regression analysis was performed only a HUGE score higher than 1.5 (p=0.003) and proteinuria higher than 2g/day (p=0.041) were independently associated to CRF progression (creatinine increment>25%).
In diabetic nephropathy patients the HUGE equation may be useful to detect the subjects prone to progressive renal failure. Wider samples will be needed to confirm this finding and, most important, its applicability to other kinds of nephropathy.
糖尿病肾病是终末期肾病的常见原因。然而，糖尿病肾病的进展速度在个体之间存在广泛的差异。我们使用 HUGE 公式评分来预测一组糖尿病肾病患者的肾脏疾病进展。
该样本由 84 名 2 型糖尿病患者组成。在治疗开始时，平均年龄为 62.1±12.5 岁，59.5%为男性。每次就诊时在诊室测量血压。每 6 个月分析血清肌酐、尿素、红细胞压积和 24 小时蛋白尿。HUGE 评分由性别、尿素和红细胞压积计算得出。
平均 HUGE 评分为 0.99±3.88。以 1.5 为截断值，得分等于或高于该值的患者（n=31）在一年后血清肌酐的升高幅度更大（41.8±62.1%），而得分低于 1.5 的患者（n=53）则为（18.7±38.6%，p=0.041）。5 名低 HUGE 评分的患者达到终末期肾衰竭（9.4%），10 名高 HUGE 评分组患者（32.3%，p=0.008）。当进行逻辑回归分析时，只有 HUGE 评分高于 1.5（p=0.003）和蛋白尿高于 2g/天（p=0.041）与 CRF 进展（肌酐增加>25%）独立相关。
在糖尿病肾病患者中，HUGE 方程可能有助于检测易发生进行性肾衰竭的患者。需要更大的样本量来证实这一发现，最重要的是，证实其在其他类型肾病中的适用性。
