摘要
AIM： To examine the risk of renal events in patients with biopsy-proven diabetic nephropathy （DN） and its possible associated factors.METHODS： Clinical and histological data of 60 pa-tients diagnosed with diabetic nephropathy were retro-spectively collected. Patients with evidence or suspicion of other nephropathies were excluded from the study. The fnal event was defned as renal replacement ther-apy （RRT） initiation or progression of chronic kidney disease （CKD）, according to the KDIGO 2012 defnition of a decrease in CKD category and a decrease in GFR of 25% or more. RESULTS： A total of 45 patients with a follow-up of at least 3 mo were included. Most of the patients presented type 2 DM, with a mean age of 58.3 years old. The time of evolution of DM was 9.6 ± 7.8 years, al-though in 13 patients, it was less than 5 years. A total of 62% of patients reached the fnal event in a mean period of 3.4 years （95%CI： 2.1-4.7）, with 21 of them requiring dialysis. The factors that were indepen-dently associated with renal survival were estimated glomerular fltration rate （eGFR） at the time of biopsy, cardiovascular disease （CVD） history and HbA1c less than 7%. Therefore, for each 10 mL/min per 1.73 m2 reduction in eGFR, we obtained a DN progression risk of HR = 2 （1.3-3.0） （P = 0.001）; patients with CVD were at greater risk for DN progression （HR = 2.8, 1.1-7.1, P = 0.032）, and CKD patients with HbA1c 〈 7% demonstrated greater renal risk than patients with HbA1c ≥ 7%, with an HR of 2.9 （1.0-8.4） （P = 0.054）.CONCLUSION： A past history of CVD is a risk fac-tor for DN progression. Levels of HbA1c less than 7% could favor an eGFR decrease in these patients.
AIM: To examine the risk of renal events in patients with biopsy-proven diabetic nephropathy(DN) and its possible associated factors.METHODS: Clinical and histological data of 60 patients diagnosed with diabetic nephropathy were retrospectively collected. Patients with evidence or suspicion of other nephropathies were excluded from the study. The final event was defined as renal replacement therapy(RRT) initiation or progression of chronic kidney disease(CKD), according to the KDIGO 2012 definition of a decrease in CKD category and a decrease in GFR of 25% or more. RESULTS: A total of 45 patients with a follow-up of at least 3 mo were included. Most of the patients presented type 2 DM, with a median age of 58.3 years old. The time of evolution of DM was 9.6 ± 7.8 years, although in 13 patients, it was less than 5 years. A total of 62% of patients reached the final event in a mean period of 3.4 years(95%CI: 2.1-4.7), with 21 of them requiring dialysis. The factors that were independently associated with renal survival were estimated glomerular filtration rate(e GFR) at the time of biopsy, cardiovascular disease(CVD) history and Hb A1 c less than 7%. Therefore, for each 10 m L/min per 1.73 m2 reduction in e GFR, we obtained a DN progression risk of HR = 2(1.3-3.0)(P = 0.001); patients with CVD were at greater risk for DN progression(HR = 2.8, 1.1-7.1, P = 0.032), and CKD patients with Hb A1 c < 7% demonstrated greater renal risk than patients with Hb A1 c ≥ 7%, with an HR of 2.9(1.0-8.4)(P = 0.054).CONCLUSION: A past history of CVD is a risk factor for DN progression. Levels of Hb A1 c less than 7% could favor an e GFR decrease in these patients.
