Abstract: SA-PO297
Characterization of Diabetic Kidney Disease in 235 Patients: Clinical and Pathological Insights with or without Nondiabetic Kidney Disease
Session Information
- Diabetic Kidney Disease: Clinical Pathology, Diagnostic and Treatment Advances
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Author
- Zhu, Qin, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
Background
Diabetic kidney involvement primarily manifests as diabetic kidney disease (DKD). However, some diabetic patients may solely present with diabetes mellitus or non-diabetic kidney disease (NDKD), or DKD combined with NDRD. This study statistically analyzed patients with DKD alone and DKD+NDKD, investigating their pathological and clinical characteristics, and identifying the independent factors associated with DKD+NDKD to aid clinical differentiation.
Methods
A retrospective analysis of 235 patients admitted to the Department of Nephrology at Hangzhou Hospital of Traditional Chinese Medicine was conducted between 2014-7 and 2022-12. These patients underwent renal biopsy and received a pathology-based diagnosis of DKD. They were categorized into the DKD alone group (93 cases) and the DKD+NDKD group (142 cases).DKD pathology grading criteria published in the American Journal of Kidney Diseases were used as a reference for grading.
Results
In the DKD alone group, gender distribution was even, with ages mainly between 50-59 years, and a disease duration of less than 5 years, primarily presenting nodular diabetic glomerulosclerosis. In contrast, the DKD+NDKD group had a higher male incidence, a wider age range, longer disease duration, and prevalent diffuse diabetic glomerulosclerosis. Acute and chronic tubulointerstitial lesions and IgA nephropathy were the predominant types of combined NDKD, accounting for 40.14% and 35.21%, respectively. Clinical correlation analysis revealed associations between glomerular grading, tubulointerstitial lesions, renal arteriolar vitelliform lesions, renal vascular atherosclerosis, and clinical parameters such as 24-hour urine protein, hemoglobin, and urinary specific gravity. Multifactorial logistic regression analysis identified independent factors affecting DKD+NDKD, including body mass index, serum creatinine (Scr), microscopic erythrocyte grade, urinary immunoglobulin G (IgG)/creatinine ratio, and serum immunoglobulin A (IgA).
Conclusion
Our research underscores distinctions in age, gender distribution, disease duration, and renal pathology between DKD alone and DKD+NDKD groups. Additionally, significant discriminative factors including BMI, Scr, microscopic erythrocyte grade, UIgG/urine creatinine ratio, and serum IgA levels help differentiate DKD from NDKD, thereby enabling personalized treatment approaches.