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BMC Nephrology
Published in: BMC Nephrology 1/2020

01-12-2020 | Ciclosporine | Research article

The impact of coexisting diabetes mellitus on clinical outcomes in patients with idiopathic membranous nephropathy: a retrospective observational study

Authors: Zhiyong Xie, Zhilian Li, Wei Dong, Yuanhan Chen, Ruizhao Li, Yanhua Wu, Huaban Liang, Zhiming Ye, Shuangxin Liu, Wei Shi, Xinling Liang

Published in: BMC Nephrology | Issue 1/2020

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Abstract

Background

Idiopathic membranous nephropathy (IMN) is frequently coexisted with diabetes mellitus (DM). Few researches investigate clinical outcomes in IMN patients coexisting diabetes mellitus (DM), including remission rates, renal survival and complications. Concurrent DM also pose therapeutic challenges to IMN patients due to the influence of glucocorticoids and immunosuppressant on metabolic disorders. We performed this study to investigate the impact of DM on clinical outcomes in IMN and the influence of therapeutic regime on metabolic parameters in diabetic IMN patients.

Methods

Two hundred and six adult hospitalized patients diagnosed with biopsy-proven IMN were retrospectively studied, including 42 patients coexisted with DM. Clinical outcomes including remission rates, renal outcome and complications were compared between groups. Impact of cyclophosphamide and ciclosporin on metabolism and complications were analyzed in IMN patients coexisting DM.

Results

IMN patients coexisted with DM were presented with advanced age, lower level of eGFR and hemoglobin. Patients coexisted with DM experienced worse renal function deterioration and higher incidence of infection. COX regression analysis showed that DM was an independent risk factor for renal function deterioration in IMN patients. There was no significant difference in remission rates and incidence of venous thromboembolism between two groups. Further exploration on the impact of therapeutic regimens on complications and metabolism showed that cyclophosphamide and ciclosporin had no significant difference in incidence of complications including infection and venous thromboembolism, and posed comparable influences on blood glucose, uric acid and blood lipids in IMN patients coexisted with DM.

Conclusion

Coexisting DM was an independent risk factor for renal function deterioration in IMN patients but did not influence the remission of proteinuria. Glucocorticoids in combination with cyclophosphamide or ciclosporine had similar impact on complications and metabolic index including blood glucose, uric acid and blood lipids in IMN patients coexisted with DM.
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Metadata
Title
The impact of coexisting diabetes mellitus on clinical outcomes in patients with idiopathic membranous nephropathy: a retrospective observational study
Authors
Zhiyong Xie
Zhilian Li
Wei Dong
Yuanhan Chen
Ruizhao Li
Yanhua Wu
Huaban Liang
Zhiming Ye
Shuangxin Liu
Wei Shi
Xinling Liang
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2020
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-020-01878-7

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