National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
Department of Nephrology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Ren Fail. 2022 Dec;44(1):1104-1111. doi: 10.1080/0886022X.2022.2094806.
This study aims to analyze the characteristics of idiopathic membranous nephropathy (iMN) with nondiabetic urine glucose during the follow-up. We retrospectively analyzed the data of 1313 patients who were diagnosed iMN. The prevalence of nondiabetic urine glucose during follow-up was 10.89%. There were significant differences between the patients with nondiabetic urine glucose and those without urine glucose in gender, hypertension ratio, proteinuria, N-acetyl-β-glucosaminidase, retinol binding protein, serum albumin, serum creatinine (Scr), cholesterol, triglyceride and positive anti-phospholipase A2 receptor antibody ratio, glomerular sclerosis ratio, acute and chronic tubular injury lesion at baseline. To exclude the influence of the baseline proteinuria and Scr, case control sampling of urine glucose negative patients was applied according to gender, baseline proteinuria and Scr. The proteinuria nonremission (NR) ratio was 45.83 versus 12.50% of the urine glucose positive group and case control group. Partial remission (PR) ratio of the two groups was 36.46 versus 23.96% and complete remission (CR) ratio was 19.79% versus 63.54%, respectively. Patients with urine glucose had higher risk of 50% estimated glomerular filtration rate (eGFR) reduction. Cox regression showed that urine glucose and baseline Scr were risk factors of 50% reduction of eGFR. Urine glucose remission ratio of the patients with proteinuria NR, PR, and CR was 13.33, 56.25, and 94.73% ( < 0.005). Patients who got urine glucose remission also had better renal survival. In conclusion, non-diabetic urine glucose was closely related to proteinuria. It could be applied as a tubular injury marker to predict renal function.
本研究旨在分析随访期间伴有非糖尿病尿糖的特发性膜性肾病（iMN）的特征。我们回顾性分析了 1313 例确诊为 iMN 的患者数据。随访期间非糖尿病尿糖的患病率为 10.89%。伴有尿糖和不伴尿糖的患者在性别、高血压比例、蛋白尿、N-乙酰-β-氨基葡萄糖苷酶、视黄醇结合蛋白、血清白蛋白、血清肌酐（Scr）、胆固醇、甘油三酯和抗磷脂酶 A2 受体抗体阳性率、肾小球硬化比例、基线急性和慢性肾小管损伤病变方面存在显著差异。为排除基线蛋白尿和 Scr 的影响，根据性别、基线蛋白尿和 Scr 对尿糖阴性患者进行病例对照采样。尿糖阳性组和病例对照组的蛋白尿未缓解（NR）比例分别为 45.83%和 12.50%。两组部分缓解（PR）比例分别为 36.46%和 23.96%，完全缓解（CR）比例分别为 19.79%和 63.54%。有尿糖的患者发生 eGFR 降低 50%的风险更高。Cox 回归显示尿糖和基线 Scr 是 eGFR 降低 50%的危险因素。蛋白尿 NR、PR 和 CR 患者的尿糖缓解比例分别为 13.33%、56.25%和 94.73%（ < 0.005）。尿糖缓解的患者肾功能也更好。总之，非糖尿病尿糖与蛋白尿密切相关，可作为肾小管损伤标志物预测肾功能。
