scholarly journals Clinical Predictors of Nondiabetic Kidney Disease in Patients with Diabetes: A Single-Center Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Francesco Fontana ◽  
Rossella Perrone ◽  
Francesco Giaroni ◽  
Gaetano Alfano ◽  
Silvia Giovanella ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Kidney Biopsy ◽  
Kidney Diseases ◽  
Lower Proportion ◽  
Diabetic Patients ◽  
Histopathological Diagnosis ◽  
Single Center ◽  
Clinical Predictors ◽  
Cross Sectional ◽  
Patients With Diabetes

Background. Although diabetic kidney disease (DKD) could affect up to one-third of patients with diabetes mellitus (DM), these patients can develop kidney diseases different from DKD, or these conditions can superimpose on DKD. Several potential predictors of nondiabetic kidney disease (NDKD) have been proposed, but there are no definitive indications available for kidney biopsy in diabetic patients. Methods. We designed a single-center, cross-sectional, and retrospective cohort study to identify clinical and laboratory factors associated with a diagnosis of NDKD after native kidney biopsy in diabetic patients and to investigate differences in time to end-stage kidney disease (ESKD) in patients with a diagnosis of DKD and NDKD. Results. Of 142 patients included in our analysis, 89 (62.68%) had a histopathological diagnosis of NDKD or mixed NDKD + DKD. Patients in the NDKD group had significantly lower HbA1C, lower prevalence of diabetic retinopathy (DR), and less severe proteinuria, and there was a lower proportion of patients with nephrotic syndrome; the DKD group had significantly lower proportion of patients with hematological conditions. In the multivariate binary logistic regression, only absence of DR and presence of a hematological condition significantly predicted NDKD after adjustment for age and sex. Time to ESKD was significantly higher in patients with NDKD or mixed forms than in those with DKD. Conclusions. After a careful selection, more than half of kidney biopsies performed in diabetic patients can identify NDKD (alone or with concomitant DKD). Absence of DR and coexistence of a hematological condition (especially MGUS) were strong predictors of NDKD in our cohort.

scholarly journals Superimposed Nephrotic Syndrome in Diabetic Patients: 15 Cases of Mismatched Clinicopathological Correlation

2020 ◽  
Vol 5 (07) ◽  
pp. 252-256
Author(s):  
Kamel El-Reshaid ◽  
Shaikha Al-Bader
Keyword(s):  
Nephrotic Syndrome ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Kidney Biopsy ◽  
Case Series ◽  
Diabetic Patients ◽  
Clinicopathological Correlation ◽  
Diabetic Kidney ◽  
Patients With Diabetes ◽  
Rule Out

The spectrum of renal disease in patients with diabetes encompasses both diabetic kidney disease (including albuminuric and non-albuminuric phenotypes) and non-diabetic kidney disease (NDKD). Acute nephrotic syndrome (NS) with short duration of diabetes indicates NDKD. Moreover, such presentation is atypical in patients with IgA nephropathy and pre-eclampsia and hence warrants kidney biopsy to rule out treatable glomerulopathy. In this case series; we present our experience with 15 patients with atypical NS and outline their management.

scholarly journals Intra-body dynamics of d-serine reflects the origin of kidney diseases

2021 ◽  
Author(s):  
Hiroki Okushima ◽  
Yukimasa Iwata ◽  
Atsushi Hesaka ◽  
Eri Sugimori ◽  
Tatsuhiko Ikeda ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
High Performance ◽  
Kidney Biopsy ◽  
Kidney Diseases ◽  
Two Dimensional ◽  
Single Center ◽  
Body Dynamics ◽  
Urinary Levels ◽  
Multivariate Cluster

Abstract Introduction d-Serine, present only in trace amounts in humans, is now recognized as a biomarker of chronic kidney disease (CKD). CKD is heterogeneous in its original kidney diseases, whose diagnoses require kidney biopsy. In this study, we examined whether the intra-body dynamics of d-serine, indexed by its blood and urinary levels, reflects the origin of kidney diseases. Methods Patients with six kinds of kidney disease undergoing kidney biopsy were enrolled in a single center. Levels of d- and l-serine were measured using two-dimensional high-performance liquid chromatography. The associations between the origin of kidney diseases and the intra-body dynamics of d-serine were examined using multivariate cluster analyses. Results Unlike the non-CKD profile, patients with CKD showed broadly-distributed profiles of intra-body dynamics of d-serine. The plasma level of d-serine plays a key role in the detection of kidney diseases, whereas a combination of plasma and urinary levels of d-serine distinguished the origin of CKD, especially lupus nephritis. Conclusion Intra-body dynamics of d-serine have the potential to predict the origin of kidney diseases. Monitoring of d-serine may guide specific treatments for the origin of kidney diseases.

scholarly journals MO638ANEMIA IN DIABETIC PATIENTS REFLECTS SEVERE TUBULOINTERSTITIAL INJURY AND ASSISTS CLINICALLY IN PREDICTING DIAGNOSIS OF DIABETIC NEPHROPATHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Soichiro Yokota ◽  
Kenji Ito ◽  
Maho Watanabe ◽  
Koji Takahashi ◽  
Naoko Himuro ◽  
...  
Keyword(s):  
Renal Function ◽  
Regression Analysis ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Kidney Biopsy ◽  
Renal Pathology ◽  
Diabetic Patients ◽  
Pathological Findings

Abstract Background and Aims Diabetic nephropathy (DN) is currently a leading cause of end-stage kidney disease worldwide. Kidney biopsy is generally performed in diabetic patients to discriminate between DN and non-diabetic kidney disease (NDKD), and to provide more specific treatments. In addition to conventional predicting factors of DN, recent studies suggested the predictive value of anemia in the diagnosis of DN, however detailed pathophysiology and the significance of anemia in renal pathology are not fully understood. This study aimed to investigate the impact of anemia on renal pathology and clinical course in patients who underwent kidney biopsy. Method We reviewed 81 patients (60.4 ± 13.7 years, 54 men and 27 women) with type 2 diabetes who underwent percutaneous kidney biopsy in Fukuoka University Hospital from January 2001 through March 2020. DN was diagnosed by mesangial expansion or nodular glomerulosclerosis observed under a light microscope, and immunofluorescence assisted in differentiating NDKD from DN. Anemia was defined as hemoglobin level <13 g/dL in males and <12 g/dL in females in accordance with the World Health Organization standards. Laboratory and pathological findings, and clinical courses were investigated. Results According to their pathological findings, patients were classified into two groups: isolated DN (DN group, n=30) and NDKD alone or concurrent DN (NDKD group, n=51). There were 11 types of NDKD. Of these, membranous nephropathy was the most common (23.5%), followed by IgA nephropathy (17.6%), and crescentic glomerulonephritis (13.7%). In multiple logistic regression analysis, absence of severe hematuria (odds ratio (OR) 11.66, 95% confidence interval (CI) 1.68 - 89.9) and presence of anemia (OR 11.38, 95% CI 2.51 - 51.52) were significantly related with the diagnosis of DN. Akaike’s information criterion (AIC) and net reclassification improvement (NRI) analyses revealed improved predictive performance by adding anemia to the conventional factors (AIC 100.152 to 91.844; NRI 27.0%). The tissues of patients in the DN group demonstrated more severe interstitial fibrosis and tubular atrophy (IF/TA) than the NDKD group (p<0.05) regardless of the rate of global glomerulosclerosis (figure), and IF/TA was related to the prevalence of anemia (odds ratio: 7.31, 95% confidence interval: 2.33 - 23.00) in multivariate regression analysis. These results suggest DM-associated severe IF/TA (compared with NDKD) impaired erythropoietin production, resulting in earlier anemia, independent of glomerular injuries and renal function. Furthermore, the renal prognosis was significantly better in the NDKD group than in the DN group using Log-rank test (p<0.05). Conclusion DN is associated with anemia because of severe IF/TA regardless of renal function, and anemia helps clinician discriminate clinically between isolated DN and NDKD.

scholarly journals Association of Retinopathy with Chronic Kidney Disease in Diabetes Mellitus

2018 ◽  
Vol 8 (3) ◽  
pp. 210-214
Author(s):  
Rushda Sharmin Binte Rouf ◽  
SM Ashrafuzzaman ◽  
Zafar Ahmed Latif
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Diabetic Retinopathy ◽  
Kidney Disease ◽  
Strong Association ◽  
Albumin Excretion Rate ◽  
Cross Sectional Study ◽  
Fundus Photography ◽  
Diabetic Patients ◽  
Cross Sectional

Background: Diabetic retinopathy (DR) and nephropathy are two major complications of diabetes mellitus carrying significant morbidity and mortality. In this study DR was investigated in different stages of chronic kidney disease (CKD) to find out possible association of these two devastating complications.Methods: This cross-sectional study was conducted in 150 diabetic patients having CKD in BIRDEM. CKD was defined as estimated glomerular filtration rate (eGFR) of <60ml/min/1.73m2and/or urinary albumin excretion rate (UAER) >30 mg/day in at least two occasions in 3 months apart. Retinopathy was assessed by direct fundoscopic examination and confirmed by color fundus photography. Severe DR (SDR) included proliferative diabetic retinopathy, severe non-proliferative DR and maculopathy; whereas microaneurysm regarded as non-severe retinopathy.Results: Majority (68%) of the respondents had some form of retinopathy (38.35% SDR and 29.65% nonsevere). There was strong association between different levels of albuminuria (UAER) and DR (p<0.0001). On the contrary DR did not correspond with stages of CKD (P=0.349). Hypertension (79.5%) and dyslipidaemia (59%) were common co-morbidities.Conclusion: This study concluded that DR prevalence was more in nephropathy along with significant association with UAER. Whereas different stages of CKD was not associated with stages of DR . This finding focused the necessity of regular retinal examination irrespective of the stage of renal involvement.Birdem Med J 2018; 8(3): 210-214

scholarly journals Ultrasound Assessment of the Median Nerve Does Not Adequately Discriminate the Carpal Tunnel Syndrome among Patients Diagnosed with Diabetes

Diabetology ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 226-231
Author(s):  
Carlos Antonio Guillen-Astete ◽  
Monica Luque-Alarcon ◽  
Nuria Garcia-Montes
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Cross Sectional Area ◽  
Diabetic Patients ◽  
Sectional Area ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Ultrasound Assessment ◽  
Tunnel Syndrome

Background: Carpal tunnel syndrome is the most prevalent peripheral nerve entrapment condition of the upper limb. Among metabolic risk factors, diabetes is considered the most relevant. Although wrist ultrasound assessment of the median nerve has demonstrated a good correlation with the gold standard for the diagnosis of this syndrome, neurophysiological study, its usefulness in patients with diabetes is questionable because the compressive phenomenon is not the predominant one. Method: We conducted a retrospective study to compare the clinical and median nerve ultrasound features of patients with carpal tunnel syndrome previously diagnosed or not diagnosed with diabetes. Additionally, a linear multivariate regression analysis was performed to determine to what extent the cross-sectional area of the median nerve was dependent on the condition of diabetes by fixing other variables such as sex, age, or time of evolution. Results: We included 303 records of patients (mean age 44.3 ± 11.7 years old, 57.89% female, mean of time of evolution 13.6 ± 8.3 months) from 2012 to 2020. The cross-sectional area of the median nerve was 10.46 ± 1.44 mm2 in non-diabetic patients and 8.92 ± 0.9 mm2 in diabetic patients (p < 0.001). Additionally, diabetic patients had a shorter time of evolution (7.91 ± 8.28 months vs. 14.36 ± 0.526 months, p < 0.001). In the multivariate analysis, the resultant model (fixed R-square = 0.659, p = 0.003) included a constant of the following four variables: the evolution time (Beta coeff. = 0.108, p < 0.001 95% CI 0.091 to 0.126, standardized coeff. = 0.611), the condition of diabetes (Beta coeff. = −0.623, p < 0.001 95% CI −0.907 to −0.339, standardized coeff. = −0.152), the severity (Beta coeff. = 0.359, p = 0.001 95% CI 0.147 to 0.571, standardized coeff. = 0.169), and the masculine sex (Beta coeff. = 0.309, p = 0.003, 95% CI 0.109 to 0.509, standardized coeff. = 0.103). Conclusions: Ultrasound assessment of the median nerve in patients with diabetes is not a useful tool to confirm whether carpal tunnel syndrome should be diagnosed or not diagnosed.

scholarly journals Hypoglycemia Prevention Practice and Associated Factors Among Patients with Diabetes Mellitus Following at Public Hospitals of Central Zone, Tigray, Ethiopia, 2018

2019 ◽  
Author(s):  
Gebrewahd Bezabh Gebremichael ◽  
Teklewoini Mariye Zemichael
Keyword(s):  
Diabetes Mellitus ◽  
Associated Factors ◽  
Central Zone ◽  
Public Hospitals ◽  
P Value ◽  
Diabetic Patients ◽  
Binary Logistic Regression Model ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
At Home

Abstract Background Hypoglycemia is an acute medical situation that occurs when blood sugar falls below the recommended level. Even though, hypoglycemia prevention practice in the management of diabetes mellitus is one cornerstone in controlling the effect of hypoglycemia, hypoglycemia prevention practice among patients with diabetes mellitus is insufficiently studied. Moreover, the existed scarce literature in Ethiopia revealed hypoglycemia prevention practice is inadequate. Thus, this study tried to assess hypoglycemia prevention practices and associated factors among diabetic patients. Methods Hospital-based, cross-sectional study design was employed from April one to March one 2018 in Central Zone of Tigray Regional state of Ethiopia. A total of 272 diabetes mellitus patients were selected by systematic random sampling method from study area. The collected data was checked for its completeness and then entered into Epi data version 3.1 then cleaned and analyzed using SPSS version 23. Binary logistic regression model (AOR, 95% CI and p-value < 0.05) was used to determine the predictors of hypoglycemia prevention practice. Results the mean age of respondents was 52.19 years and about 100 (63.2%) had good hypoglycemia prevention practice. Knowledge regarding hypoglycemia [AOR = 10.34; 95% CI [5.41, 19.89]], having a glucometer at home [AOR=3. 02; 95% CI [1.12, 8.12]], attitude regarding diabetes mellitus [AOR = 2.36 CI [1.26, 4.39]], being governmental employee [AOR=5. 19, 95% CI [1.63, 16.58]] and being divorced [AOR = 0.13, 95% CI [0.32, 0.53]] were found significantly associated with good hypoglycemia prevention practice. Conclusion Around two third of the study participants were found to have good hypoglycemia prevention practice. Good knowledge and favorable attitude toward diabetes mellitus, having glucometer at home, being governmental employee and divorced were found to be the predictors of good hypoglycemia prevention practice.

scholarly journals Psychiatric Disorders in Diabetic Patients in Rafsanjan

2021 ◽  
pp. 1-4
Author(s):  
Reza Bidaki ◽  
Parvin Agha Mohamad Hasani ◽  
Maryam Alireza Zade ◽  
Rezvan Sadr Mohammadi ◽  
Reza Bidaki ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Common Mental Disorders ◽  
Risk Groups ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Demographic Questionnaire ◽  
Patients With Diabetes ◽  
Diabetes Center

Objective: To determine prevalence rates, associated features, and risk factors for psychiatric disorders subsequent to the diagnosis of IDDM. Methods: In this cross-sectional study were been selected 100 randomly who referred to Rafsanjan Diabetes Center. The data of this study is gathered demographic questionnaire and Minnesota Multi-phasic Personality Inventory (MMPI). Data was analysed with software SPSS-17. Results: 76% of the patients were female and 24% were men 45.4% of the illiterate population. The results showed hypochondriasis (22%) and schizophrenia (19%) and depression (11%) are three psychiatric disorders that patients with diabetes in high-risk groups have reported. Conclusion: The present study demonstrated that about 30-45% of patients with diabetes suffered from common mental disorders. The prevalence of some psychiatric disorders is considerable in diabetic patients in Rafsanjan.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN ASUPAN SERAT PENDERITA DM DI POLI PENYAKIT DALAM RSUD Dr. Hi. ABDUL MOELOEK PROVINSI LAMPUNG TAHUN 2014

2017 ◽  
Vol 1 (2) ◽  
pp. 107
Author(s):  
Usdeka Muliani
Keyword(s):  
Diabetic Patient ◽  
Bivariate Analysis ◽  
Diabetic Patients ◽  
Fiber Intake ◽  
Nutritional Counseling ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Knowledge And Attitude ◽  
Sugar Levels ◽  
Gender Knowledge

Indonesia is now facing degenerative diseases such as diabetes. From previous studies found fiber intake patients with DM is still much less than that recommended, while the fiber is very useful to control blood sugar levels in diabetic patient. The purpose of this study was to determine the factors associated with fiber intake in patients with diabetes mellitus disease in internist clinic Dr H. Abdul Moeloek Hospital Lampung 2014? The experiment was used analytic research by cross sectional approach, a sample of 48 respondents. Data were analyzed by univariate and bivariate. The study concluded  the most respondents: (1) age 46-65 years 66.7%; (2) 70.8% of the female sex; (3) sufficient knowledge of fiber 56.2% (4)  never received nutritional counseling; (7) 85.4% less fiber intake. From the results of the bivariate analysis found no relationship between gender, knowledge, attitudes, education, and nutrition counseling with fiber intake respondents. Relative levels for respondents with knowledge and attitude toward less fiber, and fiber intake respondents are less good then advice the authors need to increase cooperation between the clinic personnel in order to refer all patients with DM to nutrition clinic in order to obtain nutritional counseling. Other suggestions in order to do further research to find out why fiber intake of diabetic patients are still lacking, and the study of other factors such as psychological, social culture, physical state, and the state of nutrition associated with fiber intake in diabetic patient

scholarly journals Dyslipidemia: A Trigger for Coronary Heart Disease in Romanian Patients with Diabetes

Metabolites ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 195 ◽  
Author(s):  
Mihnea-Alexandru Găman ◽  
Matei-Alexandru Cozma ◽  
Elena-Codruța Dobrică ◽  
Nicolae Bacalbașa ◽  
Ovidiu Gabriel Bratu ◽  
...  
Keyword(s):  
Gender Differences ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Statin Prescription ◽  
And Gender ◽  
Internal Medicine Clinic

Previous studies have reported age and gender disparities in the occurrence and therapeutic approach of dyslipidemia and (or) coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate these differences in Romanian patients with T2DM. A cross-sectional, observational, retrospective study was conducted using the medical records of T2DM patients who attended the outpatient facility of the Internal Medicine Clinic of the Clinical Emergency Hospital of Bucharest, Romania for routine check-ups in a six-month period. We analyzed the records of 217 diabetic patients (mean age 69 ± 11 years; 51.15% women). We found no significant gender differences in the occurrence of dyslipidemia, CHD or CHD + dyslipidemia or in terms of statin prescription. However; patients aged 65 years or older were significantly more affected by dyslipidemia, CHD or CHD + dyslipidemia, versus subjects aged <65 years. Further, they were more likely to be prescribed statin therapy (p < 0.0001 for all). Statins were prescribed to 67.24% of the patients with dyslipidemia; 61.01% of the subjects with CHD; and to 91.48% of the patients who had both conditions. e recorded no gender differences in the occurrence of CHD and (or) dyslipidemia in Romanian T2DM patients. Patients aged 65 years or older had a higher prevalence of CHD and/or dyslipidemia, and were more likely to be prescribed statins, versus younger counterparts. However, many T2DM patients with CHD and (or) dyslipidemia were undertreated: Nearly 33% of the subjects with dyslipidemia, and nearly 40% of the ones with CHD were not prescribed statins.

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