Prevalence, parameters of nondiabetic renal disease in patients with heavy proteinuria
Diabetic patients with nephrotic-range proteinuria have altered clinical parameters and prevalence and predictors of nondiabetic renal disease (NDRD), a recent study has shown.
In the study sample of 220 type 2 diabetes patients who underwent renal biopsy, 129 had nephrotic-range proteinuria while the remaining 91 had mild-to-moderate proteinuria. Those with heavy proteinuria had significantly lower serum albumin and higher total cholesterol (p<0.001 for both).
Isolated diabetic nephropathy (DN) and NDRD were diagnosed in 114 and 86 patients, respectively, while 20 were diagnosed to have both NDRD and DN.
Isolated DN was more common in patients with nephrotic-range proteinuria, yielding a prevalence rate of 62.8 percent (n=81). On the other hand, NDRD was more common in patients with mild-to-moderate proteinuria, with a prevalence rate of 60.4 percent (n=55).
Membranous and IgA nephropathy were the most common types of NDRD in patients with heavy and mild-to-moderate proteinuria, respectively.
Multivariate logistic regression adjusted for age, hypertension, sex and estimated glomerular filtration rate (eGFR) was used to determine the clinical predictors of NDRD. Notably, shorter diabetes mellitus (DM) duration was not a significant predictor of NDRD in those with heavy proteinuria (odds ratio [OR], 0.961; 95 percent CI, 0.910 to 1.015; p=0.153).
In contrast, longer DM duration correlated significantly with NDRD in patients with mild-to-moderate proteinuria (OR, 0.898; 0.840 to 0.960; p=0.002).
On the other hand, older age was significantly correlated with NDRD in those with heavy proteinuria (OR, 1.048; 1.013 to 1.084; p=0.006) but not in those with mild-to-moderate proteinuria (OR, 1.02; 0.972 to 0.069; p=0.423).