Abstract:
BACKGROUND:Clinical indicators for accurately distinguishing diabetic nephropathy (DN) from non-diabetic renal disease in type 2 diabetes (T2D) are lacking. This study aimed to develop and validate a nomogram for predicting DN in T2D patients with kidney disease. METHODS:A total of 302 consecutive patients with T2D who underwent renal biopsy at China-Japan Friendship Hospital between January 2014 and June 2019 were included in the study. The data were randomly split into a training set containing 70% of the patients (n = 214) and a validation set containing the remaining 30% of patients (n = 88). Multivariable logistic regression analyses were applied to develop a prediction nomogram incorporating the candidates selected in the least absolute shrinkage and selection operator regression model. Discrimination, calibration, and clinical usefulness of the prediction model were assessed using a concordance index (C-index), calibration plot, and decision curve analysis. Both internal and external validations were assessed. RESULTS:A multivariable model that included gender, diabetes duration, diabetic retinopathy, hematuria, glycated hemoglobin A1c, anemia, blood pressure, urinary protein excretion, and estimated glomerular filtration rate was represented as the nomogram. The model demonstrated very good discrimination with a C-index of 0.934 (95% CI 0.904-0.964). The calibration plot diagram of predicted probabilities against observed DN rates indicated excellent concordance. The C-index value was 0.91 for internal validation and 0.875 for external validation. Decision curve analysis demonstrated that the novel nomogram was clinically useful. CONCLUSION:The novel model was very useful for predicting DN in patients with T2D and kidney disease, and thereby could be used by clinicians either in triage or as a replacement for biopsy.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Jiang S,Fang J,Yu T,Liu L,Zou G,Gao H,Zhuo L,Li Wdoi
10.1159/000505145subject
Has Abstractpub_date
2020-01-01 00:00:00pages
130-138issue
2eissn
0250-8095issn
1421-9670pii
000505145journal_volume
51pub_type
杂志文章abstract::Clinical and pathologic findings are described in 14 patients whose main abnormality was an excessively thin glomerular basement membrane (GBM). The subjects were aged 11-51 years, the majority males: most were referred because of hematuria, but proteinuria was the main problem in 2, while hypertension or renal functi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166914
更新日期:1985-01-01 00:00:00
abstract::We report a 29-year-old female with recurrent focal glomerulosclerosis (FGS) presenting as heavy proteinuria immediately following renal transplantation. From day 13 after transplantation, daily plasma exchange was performed 6 times. Proteinuria decreased from 13 to 0.2 g/day after plasma exchange and remained to be l...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000168637
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND/AIMS:There is a critical need for more noninvasive biomarkers to identify nephritis in patients with systemic lupus erythematosus (SLE). Recent studies in a model mouse and an adult SLE patient cohort suggest that anti-basement membrane antibody levels correlate well with lupus activity and kidney injury. Th...
journal_title:American journal of nephrology
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更新日期:2015-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000501058
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The outcome-predictability of baseline and instantaneously changing serum calcium in hemodialysis patients has been examined. We investigated the mortality-predictability of time-averaged calcium values to reflect the 'cumulative' effect of calcium burden over time. METHODS:We employed a Cox model using up-...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000319861
更新日期:2010-01-01 00:00:00
abstract:PURPOSE:To explore the association between CYP3A4 and CYP3A5 gene polymorphisms and blood pressure response to amlodipine among participants from the African-American Study of Kidney Disease and Hypertension Trial randomized to amlodipine (n = 164). METHODS:Cox proportional hazards models were used to determine the ri...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000258688
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Telomere attrition is a novel risk factor for cardiovascular disease. Studies of telomere length in relation to kidney function are limited. We explored the association of kidney function with telomere length and telomere shortening. METHODS:The Heart and Soul Study is a longitudinal study of patients with ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000343495
更新日期:2012-01-01 00:00:00
abstract::Recent studies have focused attention on the possible role of zinc depletion in the pathogenesis of uremic symptoms such as dysgeusia and impotence. The present studies were undertaken to evaluate the prevalence of zinc deficiency and abnormalities of zinc metabolism in patients with end-stage renal disease. A total o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167247
更新日期:1986-01-01 00:00:00
abstract::To define the incidence of non-A, non-B (NANB) hepatitis and evaluate possible risk factors, we reviewed records of 163 patients on chronic dialysis during a 3-year period. 23 cases of NANB hepatitis occurred, 13 (27%) in 49 center dialysis, 8 (10%) in 77 home hemodialysis (p less than 0.02) and 2 (5%) in 37 peritonea...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166815
更新日期:1984-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000343140
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND/AIMS:A recent study suggests that inflammation and malnutrition are strongly associated with cardiovascular disease in dialysis patients. Endothelial lipase (EL) is a newly cloned physiological regulator of high-density lipoprotein cholesterol (HDL), which is associated with the progression of atherosclerosi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000144025
更新日期:2008-01-01 00:00:00
abstract:AIMS:Although there are plenty of data about the differences in left ventricular tissue Doppler (TD) velocities by preload reduction, only a few studies regarding right ventricular function are found in the literature. We investigated the effect of intravascular volume reduction on right ventricular function by ultrafi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000086080
更新日期:2005-05-01 00:00:00
abstract::Acute hyperammonemia is an emergent cause of central nervous system dysfunction for which renal replacement therapy is advocated. We report the successful use of continuous venovenous hemodiafiltration in this metabolic emergency, and report the calculated ammonia clearances for both continuous venovenous hemofiltrati...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013400
更新日期:1998-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000496276
更新日期:2019-01-01 00:00:00
abstract::Angiotensin-converting enzyme (ACE) inhibitor therapy has recently been shown to be effective in the treatment of post-renal transplant erythrocytosis (PTE). In an attempt to assess the effect of drug treatment on serum erythropoietin level, glomerular filtration rate, and urinary protein excretion, we prospectively e...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168856
更新日期:1995-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168985
更新日期:1996-01-01 00:00:00
abstract::Thymoglobulin (Thymoglobulin®; Genzyme, Cambridge, Mass., USA) is a polyclonal antibody which has been used in the field of transplantation over the last four decades. With an initial hesitancy, it is widely used now in the prevention and treatment of rejection following renal transplantation. Thymoglobulin's lack of ...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000351643
更新日期:2013-01-01 00:00:00
abstract::Bardoxolone methyl has been reported to cause detrimental cardiovascular events in the terminated BEACON Phase III human clinical trial via modulation of the renal endothelin pathway. However, the effects of bardoxolone methyl administration on the endothelin pathway in the heart are unknown. Our purpose in this persp...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000368563
更新日期:2014-01-01 00:00:00
abstract::To elucidate the relationship between the renal regulation of sodium and calcium excretion at extremes of sodium intake, we studied 6 normal men ingesting a fixed, 400 mg/day calcium intake and four levels of sodium intake from 10 to 1,500 mEq/day. Serum ionized calcium was not influenced by sodium intake. Blood press...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166496
更新日期:1981-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000360624
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND/AIMS:The shortage in organ supply has required the use of expanded criteria donors (ECD) for kidney transplantation. Current pre-transplant evaluations of ECD organs are based on histological, clinical or mixed criteria. This monocentric study investigates the predictivity of Karpinski's histological score o...
journal_title:American journal of nephrology
pub_type: 杂志文章
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更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Published reports examining the efficacy and safety of glucocorticoids for preserving renal function in immunoglobulin A nephropathy (IgAN) have yielded conflicting results. To systematically evaluate the efficacy and safety of glucocorticoids agents for IgAN, we conducted a meta-analysis of the published ra...
journal_title:American journal of nephrology
pub_type: 杂志文章,meta分析,评审
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更新日期:2009-01-01 00:00:00
abstract:BACKGROUND/AIMS:The mesothelium of patients undergoing peritoneal dialysis (PD) is exposed to glucose in dialysate. Glucose metabolites 3-deoxyglucosone and advanced glycation endproducts (AGEs) in the PD fluid induce peritoneal damage. Circulating factors also affect the peritoneum in the uremic model and predialysis ...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000108358
更新日期:2007-01-01 00:00:00
abstract::Thirty-one renal transplant recipients, submitted to treatment with cyclosporin in association with other immunosuppressive agents, were also treated for 9 months with two hydroxymethylglutaryl coenzyme A reductase inhibitors, simvastatin (10 mg/day) or pravastatin (20 mg/day), for concomitant hypercholesterolemia and...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000013487
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:C-reactive protein (CRP), which reflects chronic inflammation, is a strong predictor of cardiovascular mortality in hemodialysis patients. We investigated whether persistent elevation of CRP is associated with cardiac function and morphology in patients maintained on hemodialysis. METHODS:Predialysis high-s...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000085585
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Health-related quality of life (HRQOL) reflects a patient's perceived disease burden, treatment effectiveness, and health status. Given the time burden and physiologic effects of hemodialysis, patients who spend dialysis time (9-15 h/week) physically or intellectually engaged may have better HRQOL. We charac...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000492623
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Transglutaminase 2 (TGM2) is a calcium-dependent enzyme that can cross-link nearly all extracellular matrix (ECM) proteins and can facilitate cell-ECM interaction through integrins. Given the importance of the ECM in vascular calcification we tested the hypothesis that increased TGM2 activity may accelerate ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000347031
更新日期:2013-01-01 00:00:00
abstract::We retrospectively reviewed the course of 1,000 renal transplants performed in 835 recipients (758 nondiabetics) to assess the incidence of new onset posttransplant diabetes in former nondiabetics. A total of 119 (15.7%) recipients manifested posttransplant diabetes, of whom 64 (53.8%) became hyperglycemic within 3 we...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166932
更新日期:1985-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166711
更新日期:1983-07-01 00:00:00
abstract:BACKGROUND:Dietary acid load (DAL) contributes to the risk of CKD and CKD progression. We sought to determine the relation of DAL to racial/ethnic differences in the risk of end-stage renal disease (ESRD) among persons with CKD. METHODS:Among 1,123 non-Hispanic black (NHB) and non-Hispanic white (NHW) National Health ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000487715
更新日期:2018-01-01 00:00:00