Background: Diabetes mellitus (DM) has become the leading cause of chronic kidney disease (CKD). Nondiabetic renal diseases (NDRDs) have different clinicopathological features and prognosis from those of diabetic nephropathy. Our study sought to analyze the clinical and pathological features of NDRDs, in different age groups through a cross-sectional study.
Methods: All patients with type 2 DM at our center who underwent renal biopsy between March 1997 and March 2017 were screened and divided into three groups by age: Group 1 (youth group), 18-44 years old; Group 2 (middle-aged group), 45-59 years old; and Group 3 (elderly group), ≥60 years old. We analyzed the clinicopathological data and risk factors by univariate and multivariate logistic regression for NDRD of the patients to identify the features of NDRD in different age groups.
Results: We included 982 patients in the final analysis. Patients with NDRD accounted for 64.4% of all patients. IgA nephropathy (IgAN) was the most common pathological pattern in young patients with NDRD, accounting for 26.3%. In the middle-aged group, the two most common pathological patterns were IgAN and membranous nephropathy. Membranous nephropathy was the most common pathological pattern in elderly patients with NDRD, accounting for 29.3%. Consistent with pathological features, glomerular hematuria is a risk factor for NDRD in Group 1 (odds ratio [OR], 26.514; 95% confidence interval [CI], 2.503-280.910; P = 0.006). On the other hand, rapidly increasing proteinuria or nephrotic syndrome is a risk factor for NDRD in Group 2 (OR, 5.921; 95% CI, 2.061-17.013; P = 0.001) and Group 3 (OR, 90.409; 95% CI, 6.198-1318.826; P = 0.001).
Conclusions: This single-center study showed that the proportion and composition of NDRD differ among different age groups. Consistent with pathological features, some clinical indices such as hematuria and proteinuria showed different features among different age groups.
不同年龄组非糖尿病肾脏疾病患者的临床病理特征分析：一项观察性横断面研究 摘要 背景：糖尿病已成为慢性肾脏病的主要原因。和糖尿病肾病相比，非糖尿病肾脏疾病(NDRD, non-diabetic renal disease)有着不同的临床病理特征以及预后。我们的研究旨在分析不同年龄组NDRD患者的临床病理特征。 方法：我们筛选了我中心从1997年至2017年所有的经肾脏病理活检的2型糖尿病患者，并且根据年龄分为3组：组1（青年组），18-44岁；组2（中年组），45-59岁；组3（老年组），大于等于60岁。我们通过单因素及多因素logistic回归分析了NDRD的危险因素来分析不同年龄组NDRD患者的特征。 结果：我们共纳入982人。NDRD患者占比为64.4%。青年组NDRD患者中，IgA肾病是最常见的病理类型，占比为26.3%。在中年组NDRD患者中，膜性肾病和IgA肾病是最常见的两种病理类型。膜性肾病是老年组NDRD患者中最常见的病理类型，占比为29.3%。和病理特征相一致，在青年组中，血尿是NDRD的危险因素。而中年和老年组中，快速增加的蛋白尿或肾病综合征为NDRD的危险因素。 结论：我们单中心研究显示不同年龄组中NDRD的占比及构成比不同。和病理特征相一致，一些临床指标，例如血尿和蛋白尿在不同年龄组中也表现出不同的特征。.
Keywords: Age; Nondiabetic Renal Disease; Type 2 Diabetic Nephropathy.