Large kidneys predict poor renal outcome in subjects with diabetes and chronic kidney disease
نویسندگان
چکیده
BACKGROUND Renal hypertrophy occurs early in diabetic nephropathy, its later value is unknown. Do large kidneys still predict poor outcome in patients with diabetes and Chronic Kidney Disease (CKD)? METHODS Seventy-five patients with diabetes and CKD according to a Glomerular Filtration Rate (GFR, by 51Cr-EDTA clearance) below 60 mL/min/1.73 m2 or an Albumin Excretion Rate above 30 mg/24 H, had an ultrasound imaging of the kidneys and were cooperatively followed during five years by the Diabetology and Nephrology departments of the Centre Hospitalier Universitaire de Bordeaux. RESULTS The patients were mainly men (44/75), aged 62 +/- 13 yrs, with long-standing diabetes (duration:17 +/- 9 yrs, 55/75 type 2), and CKD: initial GFR: 56.5 (8.5-209) mL/min/1.73 m2, AER: 196 (20-2358) mg/24 H. Their mean kidney lenght (108 +/- 13 mm, 67-147) was correlated to the GFR (r = 0.23, p < 0.05). During the follow-up, 9/11 of the patients who had to start dialysis came from the half with the largest kidneys (LogRank: p < 0.05), despite a 40% higher initial isotopic GFR. Serum creatinine were initially lower (Small kidneys: 125 (79-320) micromol/L, Large: 103 (50-371), p < 0.05), but significantly increased in the "large kidneys" group at the end of the follow-up (Small kidneys: 129 (69-283) micromol/L, Large: 140 (50-952), p < 0.005 vs initial). The difference persisted in the patients with severe renal failure (KDOQI stages 4,5). CONCLUSIONS Large kidneys still predict progression in advanced CKD complicating diabetes. In these patients, ultrasound imaging not only excludes obstructive renal disease, but also provides information on the progression of the renal disease.
منابع مشابه
Etiology and Outcome of Chronic Kidney Disease in Iranian Children
Background Considering the significant geographical and ethnical differences in pattern of incidence, etiology and outcome of chronic kidney disease (CKD), the present study aimed to assess the etiology and outcome of CKD in Iranian children. Materials and Methods In a cross-sectional study etiology and outcome of 372 children aged 3 months to 18 years with CKD was studied during the period 199...
متن کاملuse of 99m Tc-DMSA scintigraphy in assessment of renal complications of COVID-19
ABSTRACT COVID-19 mainly affects respiratory and immune systems, but other organs like renal, cardiovascular, lung and nervous systems could also be involved in both acute and chronic settings (1, 2). There is a lot of studies that demonstrate an increasing number of long COVID-19 who continue to experience persistent symptoms weeks or even months after the initial disease. Reports suggest...
متن کاملImmunosuppressive Drugs and Kidney Post-transplant Diabetes Mellitus
Background: As the rate of renal transplantation increases, more immunosuppressive drugs such as cyclosporine A (CsA) are consumed, particularly during the early months following transplantation, leading to post-transplant diabetes mellitus (PTDM) which can cause death. Objective: The present study examined the role of CsA in causing PTDM and other effect...
متن کاملEffect of Some Calcium Channel Blockers in Experimentally Induced Diabetic Nephropathy in Rats
Diabetic nephropathy (DNP) is considered a CRD (Chronic Renal Disease); it is a major cause of illness and premature death in people with DM. The present study was designed to illustrate the role of CCBs (amlodipine and diltiazem) in prevention and treatment of DNP in rats. Eighty male albino rats weighing (130-180gm) were used in this study. These animals were subdivided into five equal groups...
متن کاملEarly Renal Histological Changes in Alloxan-Induced Diabetic Rats
Diabetes mellitus is a progressive disease. Most investigators have focused on glomerular changes in diabetic kidney and non-glomerular alterations have been less attended. The present study has been conducted to find early non-glomerular histological changes in diabetic renal tissue. Twenty male Wistar rats weighting 200-250 g were used for the diabetic group. Diabetes mellitus was induced by ...
متن کامل