Non-Proteinuric Kidney Disease in Type 2 Diabetic Patients: Clinical Insights from India
Authors/Creators
- 1. Associate Professor, Department of Nephrology, S.K. Medical College, Muzzafarpur, Bihar, India
- 2. Associate Professor, Department of Nephrology, Nalanda Medical College, Patna, Bihar, India
- 3. Assistant Professor, Department of Nephrology, Nalanda Medical College, Patna, Bihar, India
Description
Background: Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease worldwide, characterized by proteinuria and declining renal function. However, a subset of type 2 diabetic patients presents with a nonproteinuric phenotype, posing diagnostic and management challenges. The study objective was to evaluate the clinical spectrum of nonproteinuric kidney disease in individuals with type 2 diabetes (T2D), offering management implications and insights into the illness’s features. Methods: A single-center, prospective cohort study involving 115 T2D patients was conducted. Participants were categorized into proteinuric and nonproteinuric groups based on predefined criteria. Demographic, clinical, and biochemical parameters were assessed, and logistic regression analysis was performed to identify predictors of the nonproteinuric phenotype. Results: The study revealed significant variations between proteinuric and nonproteinuric groups in terms of age, BMI, blood pressure, serum creatinine, eGFR, and prevalence of diabetic retinopathy. Logistic regression analysis identified baseline proteinuria (OR 0.25, 95% CI 0.12 – 0.54), systolic blood pressure (OR 1.08, 95% CI 1.02 – 1.15), and duration of diabetes (OR 0.85, 95% CI 0.72 – 0.99) as independent predictors of the nonproteinuric phenotype. Conclusion: The study highlights the diverse clinical manifestations of DKD in T2D patients and underscores the importance of recognizing the nonproteinuric phenotype. Early identification of predictors such as baseline proteinuria, blood pressure, and duration of diabetes can aid in risk stratification and personalized management strategies to mitigate renal dysfunction progression. Recommendations: Clinicians should consider assessing for nonproteinuric DKD in T2D patients, particularly those with lower baseline proteinuria, higher systolic blood pressure, and shorter duration of diabetes. Further research is warranted to elucidate the underlying mechanisms and optimal management approaches for this phenotype.
Abstract (English)
Background: Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease worldwide, characterized by proteinuria and declining renal function. However, a subset of type 2 diabetic patients presents with a nonproteinuric phenotype, posing diagnostic and management challenges. The study objective was to evaluate the clinical spectrum of nonproteinuric kidney disease in individuals with type 2 diabetes (T2D), offering management implications and insights into the illness’s features. Methods: A single-center, prospective cohort study involving 115 T2D patients was conducted. Participants were categorized into proteinuric and nonproteinuric groups based on predefined criteria. Demographic, clinical, and biochemical parameters were assessed, and logistic regression analysis was performed to identify predictors of the nonproteinuric phenotype. Results: The study revealed significant variations between proteinuric and nonproteinuric groups in terms of age, BMI, blood pressure, serum creatinine, eGFR, and prevalence of diabetic retinopathy. Logistic regression analysis identified baseline proteinuria (OR 0.25, 95% CI 0.12 – 0.54), systolic blood pressure (OR 1.08, 95% CI 1.02 – 1.15), and duration of diabetes (OR 0.85, 95% CI 0.72 – 0.99) as independent predictors of the nonproteinuric phenotype. Conclusion: The study highlights the diverse clinical manifestations of DKD in T2D patients and underscores the importance of recognizing the nonproteinuric phenotype. Early identification of predictors such as baseline proteinuria, blood pressure, and duration of diabetes can aid in risk stratification and personalized management strategies to mitigate renal dysfunction progression. Recommendations: Clinicians should consider assessing for nonproteinuric DKD in T2D patients, particularly those with lower baseline proteinuria, higher systolic blood pressure, and shorter duration of diabetes. Further research is warranted to elucidate the underlying mechanisms and optimal management approaches for this phenotype.
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IJPCR,Vol16,Issue2,Article300.pdf
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Additional details
Dates
- Accepted
-
2024-02-20
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue2,Article300.pdf
- Development Status
- Active
References
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