Tianjin Medical Journal ›› 2022, Vol. 50 ›› Issue (12): 1292-1296.doi: 10.11958/20220425

• Clinical Research • Previous Articles     Next Articles

Effect of type 2 diabetes mellitus on the clinical outcome of primary membranous nephropathy

TIAN Zhixia1(), LI Heng2, WEI Li1, YU Xuefang3, JIA Junya1, YAN Tiekun1, LI Dong1,()   

  1. 1 Department of Nephrology, Tianjin Medical University General Hospital, Tianjin 300052, China
    2 Logistics College of Chinese Armed Police Force
    3 Department of Cardiology, Tianjin Medical University General Hospital
  • Received:2022-03-22 Revised:2022-06-20 Published:2022-12-15 Online:2022-12-30
  • Contact: LI Dong E-mail:15831023436@163.com;lidong430@126.com

Abstract:

Objective To investigate the effect of type 2 diabetes mellitus (T2DM) on the clinical outcome of primary membranous nephropathy (PMN). Methods The clinical data of patients with PMN diagnosed by renal biopsy in our hospital from November 2018 to June 2021 were retrospectively analyzed. Patients were divided into the PMN+T2DM group and the PMN group according to their past medical history and blood glucose level at admission. The baseline data and pathological features were compared between the two groups. Kaplan-Meier method was used to compare the cumulative complete response rate and cumulative deterioration of renal function between the two groups. Cox regression analysis was used to analyze the risk factors of incomplete response in patients with PMN complicated with T2DM. Results A total of 246 patients were included in this study. There were higher levels of blood glucose, uric acid and low density lipoprotein cholesterin in the PMN +T2DM group (n=61) than those of the PMN group (n=61, P<0.05),and there was lower 24-hour urinary protein level in the PMN +T2DM group (P<0.05). The pathological data showed that the proportion of stage Ⅲ+Ⅳ was higher in the PMN +T2DM group (P<0.05). Kaplan-Meier survival curve showed that there was a lower cumulative complete response rate of cumulative urinary protein in the PMN+T2DM group (Log-rank χ2=4.391, P<0.05). There was no significant difference in renal function deterioration (Log-rank χ2=0.899, P>0.05). Cox regression analysis showed that PMN combined T2DM (HR=1.792, 95%CI:1.166-2.753, P=0.008),and 24-hour proteinuria (HR=1.002, 95%CI: 1.000-1.003, P=0.013) were independent risk factors affecting incomplete remission in patients with PMN. Conclusion Although T2DM has no special significance for the risk of renal deterioration, it is of certain value in the evaluation of clinical outcome of such patients.

Key words: glomerulonephritis, membranous, diabetes mellitus, type 2, risk factors, complete remission

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