Original Article : Nondiabetic kidney diseases in type 2 diabetic patients
분야
의약학 > 내과학
저자
( Ye Jin Kim ) , ( Yoo Hyung Kim ) , ( Ki Dae Kim ) , ( Kang Ryun Moon ) , ( Jae Ho Park ) , ( Bo Mi Park ) , ( Hyewon Ryu ) , ( Dae Eun Choi ) , ( Ki Ryang Na ) , ( Kwang Sun Suh ) , ( Kang Wook Lee ) , ( Young Tai Shin )
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대한신장학회
간행물정보
Kidney Research and Clinical Practice(구 대한신장학회지) 2013년, 제32권 제3호, 115~120페이지(총6페이지)
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    영문초록
    Background: The aim of this study was to evaluate the clinical characteristics of nondiabetic nephropathy in type 2 diabetes mellitus patients and to find a clinical significance of renal biopsy and immunosuppressive treatment in such a patient. Methods: Renal biopsy results, clinical parameters, and renal outcomes were analyzed in 75 diabetic patients who underwent kidney biopsy at Chungnam National University Hospital from January 1994 to December 2010. Results: The three most common reasons for renal biopsy were nephrotic range proteinuria (44%), proteinuria without diabetic retinopathy (20%), and unexplained decline in renal function (20.0%). Ten patients (13.3%) had only diabetic nephropathy (Group I); 11 patients (14.7%) had diabetic nephropathy with superimposed nondiabetic nephropathy (Group II); and 54 patients (72%) had only nondiabetic nephropathy (Group III). Membranous nephropathy (23.1%), IgA nephropathy (21.5%), and acute tubulointerstitial nephritis (15.4%) were the three most common nondiabetic nephropathies. Group III had shorter duration of diabetes and lesser diabetic retinopathy than Groups I and II (P¼0.008). Group II had the lowest baseline estimated glomerular filtration rate (P¼0.002), with the greatest proportion of renal deterioration during follow-up (median 38.0 months, Po0.0001). The patients who were treated with intensive method showed better renal outcomes (odds ratio 4.931; P¼0.01). Absence of diabetic retinopathy was associated with favorable renal outcome in intensive treatment group (odds ratio 0.114; P¼0.032). Conclusion: Renal biopsy should be recommended for type 2 diabetic patients with atypical nephropathy because a considerable number of these patients may have nondiabetic nephropathies. And intensive treatment including corticosteroid or immunosuppressants could be recommended for type 2 diabetic patients with nondiabetic nephropathy, especially if the patients do not have diabetic retinopathy.
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