Dataset Information

The Diagnostic Performance of a Clinical Diagnosis of Diabetic Kidney Disease.

ABSTRACT:

Background

Diabetic kidney disease (DKD), a common cause of CKD and kidney failure, is usually diagnosed clinically. However, there is little evidence comparing the performance of a clinical diagnosis to biopsy-proven diagnosis.

Purpose of the study

Diagnostic performance of a clinical diagnosis was determined in a group of patients with diabetes and chronic kidney disease who underwent kidney biopsy after an initial clinical diagnosis.

Methods

A data analysis of 54 patients who were part of a study cohort for a prospective analysis of cardiovascular and kidney outcomes and who had undergone kidney biopsy after an initial clinical diagnosis of DKD or non-DKD (NDKD) at enrolment was used. We determined the sensitivity, specificity, and positive and negative predictive values of a clinical diagnosis of DKD.

Results

A total of 37 of 43 patients clinically diagnosed with DKD also had biopsy-proven DKD, whilst only 1 of 11 patients who had clinically diagnosed NDKD had biopsy-proven DKD. Sensitivity was 97.4%, specificity was 62.5%, positive predictive value 86%, and negative predictive value 90.9%. Comparable values were obtained when analysis was restricted to those with primary rather than secondary diagnosis of DKD or when restricted to those with only DKD found at biopsy.

Conclusion

A clinical diagnosis of DKD has high sensitivity and is unlikely to overlook cases but may lead to overdiagnosis.

SUBMITTER: Tan KS

PROVIDER: S-EPMC10381424 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

The Diagnostic Performance of a Clinical Diagnosis of Diabetic Kidney Disease.

Tan Ken-Soon KS McDonald Stephen S Hoy Wendy W

Life (Basel, Switzerland) 20230630 7

<h4>Background</h4>Diabetic kidney disease (DKD), a common cause of CKD and kidney failure, is usually diagnosed clinically. However, there is little evidence comparing the performance of a clinical diagnosis to biopsy-proven diagnosis.<h4>Purpose of the study</h4>Diagnostic performance of a clinical diagnosis was determined in a group of patients with diabetes and chronic kidney disease who underwent kidney biopsy after an initial clinical diagnosis.<h4>Methods</h4>A data analysis of 54 patient ...[more]

PMID: 37511866

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Project description:BackgroundDiabetic kidney disease (DKD) is a major burden in elderly patients with type 2 diabetes (T2DM). Low estimated glomerular filtration rate (eGFR+, < 60 mL/min/1.73 m2) and albuminuria (Alb+) are essential for the diagnosis of DKD, but their association with clinical variables and quality of care may be influenced by ageing.MethodsHere we investigated the association of clinical variables and quality of care measures with eGFR+ and Alb+ in 157,595 T2DM individuals participating to the Italian Association of Clinical Diabetologists (AMD) Annals Initiative, stratified by age.ResultsThe prevalence of eGFR+ and Alb+ increased with ageing, although this increment was more pronounced for low eGFR. Irrespective of age, both the eGFR+ and Alb + groups had the worst risk factors profile when compared to subjects without renal disease, showing a higher prevalence of out-of target values of HbA1c, BMI, triglycerides, HDL-C, blood pressure and more complex cardiovascular (CVD) and anti-diabetic therapies, including a larger use of insulin In all age groups, these associations differed according to the specific renal outcome examined: male sex and smoking were positively associated with Alb+ and negatively with eGFR+; age and anti-hypertensive therapies were more strongly associated with eGFR+, glucose control with Alb+, whereas BMI, and lipid-related variables with both abnormalities. All these associations were attenuated in the older (> 75 years) as compared to the younger groups (< 65 years; 65-75 years), and they were confirmed by multivariate analysis. Notably, Q-score values < 15, indicating a low quality of care, were strongly associated with Alb+ (OR 8.54; P < 0.001), but not with eGFR+.ConclusionsIn T2DM patients, the prevalence of both eGFR and Albuminuria increase with age. DKD is associated with poor cardiovascular risk profile and a lower quality of care, although these associations are influenced by the type of renal abnormality and by ageing. These data indicate that clinical surveillance of DKD should not be unerestimated in old T2DM patients.

Dataset Information

The Diagnostic Performance of a Clinical Diagnosis of Diabetic Kidney Disease.

Background

Purpose of the study

Methods

Results

Conclusion

Publications

The Diagnostic Performance of a Clinical Diagnosis of Diabetic Kidney Disease.

Similar Datasets

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