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Objective To analyze the clinical value of diabetic retinopathy (DR) indicators combined with urinary microalbumin/creatinine ratio (ACR) in diagnosis of diabetic kidney disease (DKD) for patients with type 2 diabetes. Methods The clinical data were retrospectively analyzed of 212 patients with type 2 diabetes mellitus complicated with kidney damage and firstly hospitalized and undergone renal biopsy in the Department of Nephropathy and Urology, the University Town Hospital of Chongqing Medical University during December 2017 to December 2020. According to the results of renal biopsy and ophthalmoscopy, all the subjects were assigned into DKD+DR group (n=96), DKD+non-DR group (n=75) and non-DKD+DR group (n=41). The general data and laboratory indexes of each group were collected and compared. The morbidity of DKD in different degrees of DR groups, risk factors for DKD and the diagnostic value of DR+ACR to DKD were analyzed. Results The levels of serum creatinine (Scr) and ACR were obviously lower, but the glomerulus filtering rate (eGFR) was markedly higher in DKD+non-DR group and non-DKD+DR group than in DKD+DR group with statistically significant difference (P<0.05); Compared with that in DKD+DR group, shorter disease course, decreased levels of mean arterial pressure (MAP), blood urea nitrogen(BUN), cystatin C (Cys-C) and 24 h urinary protein, and higher level of serum albumin (ALB) were in non-DKD+DR group with statistically significant difference (P<0.05); The morbidity ratio of DKD was obviously higher in proliferative diabetic retinopathy(PDR) group than in non-proliferative diabetic retinopathy (NPDR) group with significant difference (χ2=9.578, P=0.001). Logistic regression analysis showed that ACR, DR and PDR were the independent risk factors for DKD, while high eGFR was a protective factor (OR=0.92, P=0.004). ROC curve analysis revealed that PDR+ACR may effectively diagnose DKD with AUC of 0.88, while NPDR+ACR only have a limited diagnostic value for DKD with AUC of only 0.63. Conclusion DR combined with urinary ACR may contribute a limited value in diagnosis of DKD for patients with type 2 diabetes.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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