A retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney disease
Background Type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD) poses a serious health threat and becomes a new challenge. T2DM patients with CKD fall into three categories, diabetic nephropathy (DN), non-diabetic kidney disease (NDKD), and diabetic nephropathy plus non-diabetic kidney...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
PeerJ Inc.
2024-02-01
|
| Series: | PeerJ |
| Subjects: | |
| Online Access: | https://peerj.com/articles/16915.pdf |
| _version_ | 1797300560388423680 |
|---|---|
| author | Xi He Yuanjun Deng Beichen Tian Yixuan Zhao Min Han Yang Cai |
| author_facet | Xi He Yuanjun Deng Beichen Tian Yixuan Zhao Min Han Yang Cai |
| author_sort | Xi He |
| collection | DOAJ |
| description | Background Type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD) poses a serious health threat and becomes a new challenge. T2DM patients with CKD fall into three categories, diabetic nephropathy (DN), non-diabetic kidney disease (NDKD), and diabetic nephropathy plus non-diabetic kidney disease (DN + NDKD), according to kidney biopsy. The purpose of our study was to compare the clinical characteristics and kidney outcomes of DN, NDKD, and DN + NDKD patients. Methods Data on clinical characteristics, pathological findings, and prognosis were collected from June 2016 to July 2022 in patients with previously diagnosed T2DM and confirmed DN and or NDKD by kidney biopsy at Tongji Hospital in Wuhan, China. The endpoint was defined as kidney transplantation, dialysis, or a twofold increase in serum creatinine. Results In our 6-year retrospective cohort research, a total of 268 diabetic patients were admitted and categorized into three groups by kidney biopsy. The 268 patients were assigned to DN (n = 74), NDKD (n = 109), and DN + NDKD (n = 85) groups. The most frequent NDKD was membranous nephropathy (MN) (n = 45,41.28%). Hypertensive nephropathy was the most common subtype in the DN+NDKD group (n = 34,40%). A total of 34 patients (12.7%) reached the endpoint. The difference between the Kaplan-Meier survival curves of the DN, NDKD, and DN + NDKD groups was significant (p < 0.05). Multifactorial analysis showed that increased SBP [HR (95% CI): 1.018(1.002–1.035), p = 0.025], lower Hb [HR(95% CI): 0.979(0.961–0.997), p = 0.023], higher glycosylated hemoglobin [HR(95% CI): 1.338(1.080–1.658), p = 0.008] and reduced serum ALB [HR(95% CI): 0.952(0.910–0.996), p = 0.032] were risk factors for outcomes in the T2DM patients with CKD. Conclusions This research based on a Chinese cohort demonstrated that the risk of endpoint events differed among DN, NDKD, and DN+NDKD patients. In T2DM patients with CKD, DN patients displayed worse kidney prognosis than those with NDKD or DN + NDKD. Increased SBP, higher glycosylated hemoglobin, lower Hb, and decreased serum ALB may be correlated with adverse kidney outcomes in T2DM patients. |
| first_indexed | 2024-03-07T23:08:56Z |
| format | Article |
| id | doaj.art-3ecfbd93852a4c6b88265514efb805c8 |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-07T23:08:56Z |
| publishDate | 2024-02-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
| series | PeerJ |
| spelling | doaj.art-3ecfbd93852a4c6b88265514efb805c82024-02-21T15:05:15ZengPeerJ Inc.PeerJ2167-83592024-02-0112e1691510.7717/peerj.16915A retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney diseaseXi He0Yuanjun Deng1Beichen Tian2Yixuan Zhao3Min Han4Yang Cai5Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaBackground Type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD) poses a serious health threat and becomes a new challenge. T2DM patients with CKD fall into three categories, diabetic nephropathy (DN), non-diabetic kidney disease (NDKD), and diabetic nephropathy plus non-diabetic kidney disease (DN + NDKD), according to kidney biopsy. The purpose of our study was to compare the clinical characteristics and kidney outcomes of DN, NDKD, and DN + NDKD patients. Methods Data on clinical characteristics, pathological findings, and prognosis were collected from June 2016 to July 2022 in patients with previously diagnosed T2DM and confirmed DN and or NDKD by kidney biopsy at Tongji Hospital in Wuhan, China. The endpoint was defined as kidney transplantation, dialysis, or a twofold increase in serum creatinine. Results In our 6-year retrospective cohort research, a total of 268 diabetic patients were admitted and categorized into three groups by kidney biopsy. The 268 patients were assigned to DN (n = 74), NDKD (n = 109), and DN + NDKD (n = 85) groups. The most frequent NDKD was membranous nephropathy (MN) (n = 45,41.28%). Hypertensive nephropathy was the most common subtype in the DN+NDKD group (n = 34,40%). A total of 34 patients (12.7%) reached the endpoint. The difference between the Kaplan-Meier survival curves of the DN, NDKD, and DN + NDKD groups was significant (p < 0.05). Multifactorial analysis showed that increased SBP [HR (95% CI): 1.018(1.002–1.035), p = 0.025], lower Hb [HR(95% CI): 0.979(0.961–0.997), p = 0.023], higher glycosylated hemoglobin [HR(95% CI): 1.338(1.080–1.658), p = 0.008] and reduced serum ALB [HR(95% CI): 0.952(0.910–0.996), p = 0.032] were risk factors for outcomes in the T2DM patients with CKD. Conclusions This research based on a Chinese cohort demonstrated that the risk of endpoint events differed among DN, NDKD, and DN+NDKD patients. In T2DM patients with CKD, DN patients displayed worse kidney prognosis than those with NDKD or DN + NDKD. Increased SBP, higher glycosylated hemoglobin, lower Hb, and decreased serum ALB may be correlated with adverse kidney outcomes in T2DM patients.https://peerj.com/articles/16915.pdfDiabetic nephropathyNon-diabetic kidney diseaseType 2 diabetes mellitusKidney biopsy |
| spellingShingle | Xi He Yuanjun Deng Beichen Tian Yixuan Zhao Min Han Yang Cai A retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney disease PeerJ Diabetic nephropathy Non-diabetic kidney disease Type 2 diabetes mellitus Kidney biopsy |
| title | A retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney disease |
| title_full | A retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney disease |
| title_fullStr | A retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney disease |
| title_full_unstemmed | A retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney disease |
| title_short | A retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney disease |
| title_sort | retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney disease |
| topic | Diabetic nephropathy Non-diabetic kidney disease Type 2 diabetes mellitus Kidney biopsy |
| url | https://peerj.com/articles/16915.pdf |
| work_keys_str_mv | AT xihe aretrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease AT yuanjundeng aretrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease AT beichentian aretrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease AT yixuanzhao aretrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease AT minhan aretrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease AT yangcai aretrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease AT xihe retrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease AT yuanjundeng retrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease AT beichentian retrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease AT yixuanzhao retrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease AT minhan retrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease AT yangcai retrospectivecohortstudyofclinicalcharacteristicsandoutcomesoftype2diabeticpatientswithkidneydisease |