Amoah E, Glickman J L, Malchoff C D, Sturgill B C, Kaiser D L, Bolton W K
Department of Internal Medicine, University of Virginia Medical Center, Charlottesville.
Am J Nephrol. 1988;8(3):204-11. doi: 10.1159/000167584.
A retrospective study was done on 109 diabetic patients who had renal biopsies during 1974-1984 to determine factors identifying nondiabetic renal disease in patients with diabetes mellitus presenting with renal dysfunction. Six of 49 (12%) patients with type I and 17 of 60 (28%) with type II diabetes mellitus had other renal diseases, with or without diabetic glomerulosclerosis. Multivariate predictors of other renal disease in type I diabetes mellitus were duration less than 5 years (p less than 0.001), absence of proteinuria (p less than 0.001), and absence of neuropathy (p less than 0.05). In type II diabetes mellitus these were late age of onset (p less than 0.001), absence of neuropathy (p less than 0.05), and Caucasian race (p less than 0.005). Some patients with other diseases appeared to respond to therapy directed at their nondiabetic glomerulosclerosis disease. We emphasize the need to distinguish between the subgroup of diabetic patients with nondiabetic renal disease from the majority who have diabetic glomerulosclerosis alone. The latter group should be spared the discomforts, risks, and costs of a renal biopsy.
对1974年至1984年间接受肾活检的109例糖尿病患者进行了一项回顾性研究，以确定在出现肾功能不全的糖尿病患者中识别非糖尿病性肾病的因素。49例I型糖尿病患者中有6例（12%），60例II型糖尿病患者中有17例（28%）患有其他肾脏疾病，伴或不伴有糖尿病肾小球硬化。I型糖尿病中其他肾脏疾病的多变量预测因素为病程小于5年（p<0.001）、无蛋白尿（p<0.001）和无神经病变（p<0.05）。在II型糖尿病中，这些因素为发病年龄较晚（p<0.001）、无神经病变（p<0.05）和白种人（p<0.005）。一些患有其他疾病的患者似乎对针对其非糖尿病性肾小球硬化疾病的治疗有反应。我们强调需要将患有非糖尿病性肾病的糖尿病患者亚组与仅患有糖尿病肾小球硬化的大多数患者区分开来。后一组患者应避免肾活检带来的不适、风险和费用。
