■研究糖尿病肾病诊所(DRC)对患有糖尿病(DM)和慢性肾病(CKD)的成年人的肾功能和代谢指标的影响。
■确定了2008年1月1日至2012年12月31日在单一三级转诊中心的DRC评估的所有患者。记录2004年1月1日至2014年12月31日的连续肾脏和代谢指标,并通过线性混合效应模型分析了随时间推移的趋势。
■根据推定的CKD病因,总共确定了200例患有DM和CKD的患者,并将其细分为3类:43例(21.5%)仅患有1型DM(T1D),127(63.5%),仅2型DM(T2D),30例(15.0%)患有DM和其他CKD病因。年平均绝对值(mL/min/体表面积每年)和百分比(%/年)变化,分别,在慢性肾脏病流行病学合作中,首次DRC就诊前后的肾小球滤过率估计为:T1D的-1.59vs-3.10(P=.31)和-1.22vs-9.39(P=.06);T2D的-5.64vs-3.07(P=.004)和-10.88vs-9.94(P=.70);病因-6.50vs.0.91(P<.001)那些患有T2D的人的血糖控制恶化,而T1D患者的总胆固醇水平趋势改善.
■第一次DRC出席后,估计的肾小球滤过率下降的绝对率与那些患有T1D的人相似,但对于那些患有T2D或DM并有其他CKD病因的患者,其速度减慢。因此,对于不同的糖尿病亚人群,糖尿病和肾脏病学联合咨询的益处可能不同.
UNASSIGNED: To examine the impact of a diabetes renal clinic (DRC) on renal functional and metabolic indices in adults who have diabetes mellitus (DM) and chronic kidney disease (CKD).
UNASSIGNED: All patients evaluated at a DRC in a single tertiary referral center from January 1, 2008, to December 31, 2012, were identified. Serial renal and metabolic indices from January 1, 2004, to December 31, 2014, were recorded, and trends over time were analyzed by linear mixed-effects models.
UNASSIGNED: A total of 200 patients who had DM and CKD were identified and subdivided into 3 categories based on presumptive CKD etiology: 43 (21.5%) with type 1 DM (T1D) only, 127 (63.5%) with type 2 DM (T2D) only, and 30 (15.0%) with DM and an additional CKD etiology. Average annual absolute (mL/min per body surface area per year) and percentage (%/year) changes, respectively, in Chronic Kidney Disease Epidemiology Collaboration estimated glomerular filtration rate before vs after first DRC attendance were: -1.59 vs -3.10 (P=.31) and -1.22 vs -9.39 (P=.06) for T1D; -5.64 vs -3.07 (P=.004) and -10.88 vs -9.94 (P=.70) for T2D; and -6.50 vs +0.91 (P<.001) and -13.28 vs -2.29 (P=.001) for DM with an additional CKD etiology. Glycemic control worsened in those who had T2D, whereas trends in total cholesterol levels improved in those who had T1D.
UNASSIGNED: After first DRC attendance, the absolute rate of estimated glomerular filtration rate decline remained similar for those who had T1D, but it slowed for those who had T2D or DM with additional CKD etiology. Thus, benefits of combined diabetology and nephrology consultation may vary for different diabetic subpopulations.