PMID- 31686878
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220411
IS  - 1178-7007 (Print)
IS  - 1178-7007 (Electronic)
IS  - 1178-7007 (Linking)
VI  - 12
DP  - 2019
TI  - A Differential Diagnosis Model For Diabetic Nephropathy And Non-Diabetic Renal 
      Disease In Patients With Type 2 Diabetes Complicated With Chronic Kidney Disease.
PG  - 1963-1972
LID - 10.2147/DMSO.S223144 [doi]
AB  - PURPOSE: Differentiating between diabetic nephropathy (DN) and non-diabetic renal 
      disease (NDRD) is difficult and inefficient. The aim of the present study was to 
      create a model for the differential diagnosis of DN and NDRD in patients with 
      type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS: We consecutively screened 
      213 patients with T2DM complicated with chronic kidney disease, who underwent 
      renal biopsy at The First Affiliated Hospital of Guangxi Medical University 
      (Nanning, China) between 2011 and 2017. According to the pathological results 
      derived from the renal biopsy, the patients were divided into three groups (74, 
      130, and nine in the DN, NDRD, and NDRD superimposed with DN group, 
      respectively). Clinical and laboratory data were compared and a diagnostic model 
      was developed based on the following logistic regression model: logit(P)=+++ ... +. 
      RESULTS: We observed a high incidence of NDRD (61.0% of all patients), including 
      various pathological types; the most common type was idiopathic membranous 
      nephropathy. By comparing clinical variables, we identified a number of 
      differences between DN and NDRD. Logistic regression analyses showed that the 
      following variables were statistically significant: the absence of diabetic 
      retinopathy (DR), proteinuria within the non-nephrotic range, the absence of 
      anemia and an estimated glomerular filtration rate (eGFR) >/=90 mL/min/1.73 m(2). 
      We subsequently constructed a diagnostic model for predicting NDRD, as follows: 
      P(NDRD)=1/[1+exp(-17.382-3.339xDR-1.274xProteinuria-2.217xAnemia-1.853xeGFR-0.993xDM+20.892Bp)]. 
      P(NDRD) refers to the probability of a diagnosis of NDRD (a P(NDRD)>/=0.5 predicts 
      NDRD while a P(NDRD) <0.5 predicts DN); while DM refers to the duration of 
      diabetes. This model had a sensitivity of 95.4%, a specificity of 83.8%, and the 
      area under the receiver operating characteristic curve was 0.925. CONCLUSION: Our 
      diagnostic model may facilitate the clinical differentiation of DN and NDRD, and 
      assist physicians in developing more effective and rational criteria for kidney 
      biopsy in patients with T2DM complicated with chronic kidney disease.
CI  - (c) 2019 Yang et al.
FAU - Yang, Zhenhua
AU  - Yang Z
AD  - Department of Nephrology, The First Affiliated Hospital of Guangxi Medical 
      University, Nanning, People's Republic of China.
FAU - Feng, Luhuai
AU  - Feng L
AUID- ORCID: 0000-0002-1715-4028
AD  - Department of General Internal Medicine, The Affiliated Tumor Hospital of Guangxi 
      Medical University, Nanning, People's Republic of China.
FAU - Huang, Yu
AU  - Huang Y
AD  - Department of Nephrology, The People's Hospital of Wuzhou, Wuzhou, People's 
      Republic of China.
FAU - Xia, Ning
AU  - Xia N
AD  - Department of Endocrinology and Metabolism, The First Affiliated Hospital of 
      Guangxi Medical University, Nanning, People's Republic of China.
LA  - eng
PT  - Journal Article
DEP - 20190930
PL  - New Zealand
TA  - Diabetes Metab Syndr Obes
JT  - Diabetes, metabolic syndrome and obesity : targets and therapy
JID - 101515585
PMC - PMC6777431
OTO - NOTNLM
OT  - diabetic nephropathy
OT  - formula
OT  - logistic regression
OT  - non-diabetic nephropathy
OT  - puncture biopsy
OT  - type 2 diabetes mellitus
COIS- The authors declare that there are no conflicts of interest in this work.
EDAT- 2019/11/07 06:00
MHDA- 2019/11/07 06:01
PMCR- 2019/09/30
CRDT- 2019/11/06 06:00
PHST- 2019/07/14 00:00 [received]
PHST- 2019/09/16 00:00 [accepted]
PHST- 2019/11/06 06:00 [entrez]
PHST- 2019/11/07 06:00 [pubmed]
PHST- 2019/11/07 06:01 [medline]
PHST- 2019/09/30 00:00 [pmc-release]
AID - 223144 [pii]
AID - 10.2147/DMSO.S223144 [doi]
PST - epublish
SO  - Diabetes Metab Syndr Obes. 2019 Sep 30;12:1963-1972. doi: 10.2147/DMSO.S223144. 
      eCollection 2019.