Clinical status at first hospitalization and analysis of risk factors in 1242 patients with diabetic kidney diseases / 中华肾脏病杂志

ABSTRACT

Objective To investigate the clinical status of 1242 patients with diabetic kidney diseases (DKD) during their first hospitalization,and to analyze the risk factors of prognosis,so as to provide reference for clinical practice. Methods Retrospective case-control study was performed.Clinical data of 1242 patients diagnosed as DKD in first hospitalizaton from January 2003 to December 2008 were reviewed,and patients were followed up to realize the prognosis.Multiple regression analysis was carried out to screen the risk factors. Results Most of the patients were Mogensen stage Ⅳ or Ⅴ in their first hospitalization,accounting for 77.2％.24.8％ of cases was complicated with cardiocerebrovascular diseases.Scr of 36.6％ patients was higher than 176.8 μmol/L.One way ANOVA indicated that diabetes course,hemoglobin,serum albumin,Scr and Charlson index were significantly different among Mogensen stage Ⅲ, Ⅳ,Ⅴ patients.Logistic regression showed that age,albumin,Scr,cardiocerebrovascular diseases and Chalson index were risk factors for death in DKD patients (OR =1.057,0.908,1.002,2.006,1.371),but sex,diabetes course and hemoglobin were not risk factors,which was in accord with the resuh from 416 non-dialysis patients.Multiple linear regression analysis revealed serum albumin level was positively correlated with survival in non-dialysis DKD patients (P=0.003).The mean survival time was only 1.2145 year in 162 non-dialysis dead patients. Conclusions DKD patients in our hospital refer quite late,usually with poor conditions and complications.Most of DKD patients are Mogensen stage Ⅳ or Ⅴ in the first hospitalization.Age,serum albumin,Scr,cardiocerebrovascular diseases and Charlson index are risk factors of death,while gender,diabetes course and hemoglobin are not significantly correlated with death.In addition,serum albumin is positively correlated with survival time.Early diagnosis and management of risk factors are crucial for improving the prognosis of DKD patients.