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Kidney Week

Abstract: PO0785

Predictive Model of Non-Diabetic Nephropathy in Patients Affected by Diabetes

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Bermejo, Sheila, Vall d'Hebron Hospital Universitari, Barcelona, Catalunya, Spain
  • Agraz, Irene, Vall d'Hebron Hospital Universitari, Barcelona, Catalunya, Spain
  • Vergara, Ander, Vall d'Hebron Hospital Universitari, Barcelona, Catalunya, Spain
  • Soler, Maria Jose, Vall d'Hebron Hospital Universitari, Barcelona, Catalunya, Spain

Group or Team Name

  • on behalf of GLOSEN group
Background

Between 50-60% of diabetics with renal involvement have non-diabetic nephropathy (NDN). Renal biopsy is crucial for renal diagnosis that includes diabetic nephropathy (DN), NND, or mixed form. The objective of the current study is to provide a tool in the daily clinical practice through a predictive model of NND that is clue for the indication of renal biopsy.

Methods

Observational, retrospective and multicenter study of the pathological results of kidney biopsies in patients with diabetes from 2002 to 2014. A logistic regression analysis and the probability of presenting NND was calculated using a punctuation score.

Results

The cohort of 832 patients includes 621 men(74.6%), median age 61.7±12.8 years, creatinine 2.8±2.2mg/dl and proteinuria 2.7 (1.2-5.4)gr/24h. Time of evolution of diabetes was 10.8±8.6 years. 26.6%(n=221) of patients presented diabetic retinopathy, 18.8% (n=156) peripheral vasculopathy and 17.7%(n=147) ischemic heart disease. 288 patients (34.6%) presented microhematuria. 39.5%(n=329) presented DN, 49.6% (n=413) NDN and 10.8%(n=90) mixed forms.
In the multivariate analysis, age (OR:1.03;1.01-1.04; p=0.0002), absence of microhematuria (OR:0.6,;0.4-0.86;p=0.005), absence of diabetic retinopathy (OR:3.97;2.7-5.82;p<0.0001) and absence of peripheral vasculopathy (OR:1.61, 1.03-2.52, p=0.038) were identified as ndependent risk factors for NDN. A ROC curve with an area under the curve of 0.724 was obtained. A predictive model obtaining a score ( see figure) for each variable and finally a NDN prediction score was performed. In our new score, the number increases as increased the probability of NDN.

Conclusion

In our study, around 66% of biopsied patients with diabetes presented NDN. Microhematuria, absence of diabetic retinopathy, absence of peripheral vascular disease, and older age were identified as independent risk factors for NDN. We obtained a Score that increases as increased the probability of NDN. This could be in a next future a useful tool for the clinical indication of renal biopsy in patients with diabetes and kidney disease.