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Diabetic Retinopathy and Clinical Parameters Favoring the Presence of Diabetic Nephropathy could Predict Renal Outcome in Patients with Diabetic Kidney Disease.

Diabetic Retinopathy and Clinical Parameters Favoring the Presence of Diabetic Nephropathy could Predict Renal Outcome in Patients with Diabetic Kidney Disease.
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Hung CC, Lin HY, Hwang DY, Kuo IC, Chiu YW, Lim LM, Hwang SJ, Chen HC,


Hung CC, Lin HY, Hwang DY, Kuo IC, Chiu YW, Lim LM, Hwang SJ, Chen HC, (click to view)

Hung CC, Lin HY, Hwang DY, Kuo IC, Chiu YW, Lim LM, Hwang SJ, Chen HC,

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Scientific reports 2017 04 217(1) 1236 doi 10.1038/s41598-017-01204-6
Abstract

Diabetes duration, diabetic retinopathy (DR), and a diagnostic model have been proposed as clinical parameters favoring the presence of diabetic nephropathy (DN) in biopsied patients with diabetic kidney disease. DN, compared with non-diabetic renal disease, had poorer renal outcomes. We tested whether these clinical parameters favoring DN are associated with poorer renal outcomes in non-biopsied patients. In this study, 1330 patients with type 2 diabetes and chronic kidney disease stages 1-4 were included and divided according to diabetes mellitus (DM) duration >8 years, DR, or a diagnostic model for DN. These clinical parameters favoring DN were found in 62-77% of patients and associated with higher levels of proteinuria. In a Cox survival analysis, DR and the diagnostic model favoring DN were associated with an increased risk for end-stage renal disease with adjusted hazard ratios of 1.69 (95% CI: 1.16-2.45, P = 0.006) and 1.66 (95% CI: 1.05-2.61, P = 0.029), respectively. DR was associated with an increased risk for rapid renal disease progression. DM >8 years was not associated with renal outcome. Propensity score-matched analyses also showed similar results. In conclusion, DR and the diagnostic model favoring DN were associated with poorer renal outcomes.

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