SP454NON-DIABETIC RENAL DISEASE IN TYPE 2 DIABETIC PATIENTS: PREVALENCE, CLINICAL PREDICTORS ANDOUTCOMES

Background: In diabetic patients a good proportion of nephropathy is due to nephropathy other than diabetic renal disease. The detection of superimposed primary nondiabetic renal disease in diabetic patients has an obvious prognostic and therapeutic importance. Objectives: To find out the proportion of diabetic subjects suffering from nondiabetic renal disease (NDRD) and to describe histological varieties in appropriate group. Materials and Methods: This crosssectional study was done in Department of Nephrology, Dhaka Medical College & Hospital, Dhaka from August 2015 to October 2016. Total 37 type 2 diabetic patients were selected. Renal biopsy was done and four cases were excluded due to inadequate sample. Tissue was sent for histopathology and direct immunofluorescence (DIF) examination. On the basis of histological diagnosis of biopsy reports patients were divided into three groups. Group I: Isolated NDRD, Group II: NDRD superimposed on diabetic nephropathy (mixed lesion) and Group III: Isolated diabetic nephropathy (DN). Each patient was evaluated for retinopathy from Ophthalmology department. Based on the presence or absence of retinopathy 33 patients were again divided into two groups. Group A includes patients with diabetic retinopathy (DR) and Group B includes patients without diabetic retinopathy. Results: NDRD was found in 57.6% cases, NDRD plus diabetic nephropathy (DN) in 21.2% and isolated DN in 21.2% cases. In Group A (patients with DR) NDRD, DN and mixed lesion were present in 7 (41.2%), 5 (29.4%) and 5 (29.4%) cases. In Group B (patients without DR) NDRD, DN and mixed lesion were present in 12 (75%), 2 (12.5%) and 2 (12.5%) cases respectively. p value (0.189) was not significant. Conclusion: Kidney disease other than diabetic nephropathy can occur in type 2 diabetic patients. In this study NDRD was found in high frequency. Lack of retinopathy is a poor predictor of nondiabetic kidney disease. Therefore, renal biopsy should be recommended in type 2 diabetic patients with risk factors of NDRD for accurate diagnosis, prompt initiation of disease-specific treatment and ultimately better renal outcome. J Enam Med Col 2020; 10(2): 73-78

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The association between serum uric acid to creatinine ratio and renal disease progression in type 2 diabetic patients in Chinese communities

Journal of Diabetes and its Complications ◽

10.1016/j.jdiacomp.2018.10.013 ◽

2019 ◽

Vol 33 (7) ◽

pp. 473-476

Author(s):

Yao Chunlei ◽

Gu Liubao ◽

Wang Tao ◽

Xing Changying

Keyword(s):

Uric Acid ◽

Renal Disease ◽

Disease Progression ◽

Serum Uric Acid ◽

Diabetic Patients ◽

Creatinine Ratio ◽

Type 2 Diabetic Patients ◽

Renal Disease Progression ◽

Type 2 Diabetic

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P1274THE CHARACTER OF CARDIAC REMODELING AND VALVE CALCIFICATION IN TYPE 2 DIABETIC PATIENTS WITH END-STAGE RENAL DISEASE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1274 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Oleksandr Susla ◽

Mykola Shved ◽

Zoriana Litovkina ◽

Svitlana Danyliv ◽

Anatoliy Gozhenko

Keyword(s):

Renal Disease ◽

Cardiac Remodeling ◽

End Stage Renal Disease ◽

Systolic Dysfunction ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Stage Renal Disease ◽

End Stage ◽

Type 2 Diabetic

Abstract Background and Aims Systematic analysis of cardiac remodeling features in type 2 diabetic patients with end-stage renal disease (ESRD) is important both in stratification of cardiovascular risk and in choice of adequate treatment strategies. The lack of number and fragmentation of studies, the ambiguity of their data regarding the problem of myocardial reconstruction and cardiac valve calcification (CVC) under these conditions have substantiated the need for this study, its relevance and purpose. Method 136 ESRD patients on chronic hemodialysis (HD) were included in this observational cross-sectional study (men, 78; age, 53.9±1.0 years; HD duration, 47.6±4.2 months). The study was performed in accordance with the provisions of the Declaration of Helsinki last revision. Depending on the presence/absence of diabetic nephropathy (DN) all patients were divided into two groups: the 1st one – without DN (n=88); the 2nd one – with DN (n=48). A complete ultrasound examination of the cardiac structure and function including CVC analysis was performed. Data are presented as means±SEM. Mann-Whitney U-test was used for comparison of the quantitative variables, χ2-test – qualitative ones. Results Left ventricular (LV) hypertrophy (93.8 vs. 78.4%, р=0.020) and eccentric hypertrophy (47.9 vs. 28.4%, р=0.023) were diagnosed more often in patients with DN than those without diabetes. Prevalence of pseudonormal and restrictive types of LV diastolic dysfunction (62.5 vs. 28.4%, p<0.001), systolic dysfunction (27.1 vs. 9.1%, p=0.006) and pulmonary hypertension (PH) (64.6 vs. 35.2%, p=0.001) were significant in the 2nd group. CVC (66.6 vs. 38.6%, р=0.002), combined calcification of mitral (MV) and aortal (AV) valves (35.4 vs. 13.6%, p=0.003), stenoses of MV (16.7 vs. 3.4%, p=0.007) and AV (39.6 vs. 15.9%, p=0.004), and insufficiency of MV (66.7 vs. 44.3%, p=0.013) and AV (35.4 vs. 14.8%, p=0.006) were recorded more often in HD patients with DN. LV myocardial mass index (181.0±7.2 vs. 155.0±5.3 g/m2, p=0.001) as well as right ventricle (RV) diameter (2.80±0.09 vs. 2.47±0.04 cm, p=0.003) were also greater in the 2nd group. Conclusion In type 2 diabetic patients with ESRD occurs maladaptive cardiac remodeling with predominance of unfavourable (especially eccentric) types of LV hypertrophy, RV dilatation, PH, severe LV diastolic and systolic dysfunction, and widespread combined calcification of MV and AV with the valve defects. The identification of risk factors for the progression of the pathological reconstruction of myocardium and CVC in HD patients with DN will be the subject of our further research.

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