Clinical factors associated with non-diabetic renal disease in diabetic latin american patients, histopathological findings, and predictive model

ABSTRACT: The prevalence of diabetes was reported by the World Health Organization from 180 million in 1980 to 422 million in 2014, differentiating those patients who have diabetes. Still, it is not the cause of kidney damage. It is actually in the presence of non-diabetic renal disease (NDRD) or wh...

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Autores:
Garay Guerrero, Jennifer
Pinilla Sogamoso, Jorge Luis
Tipo de recurso:
Tesis
Fecha de publicación:
2022
Institución:
Universidad de Antioquia
Repositorio:
Repositorio UdeA
Idioma:
eng
OAI Identifier:
oai:bibliotecadigital.udea.edu.co:10495/29539
Acceso en línea:
http://hdl.handle.net/10495/29539
Palabra clave:
Diabetes mellitus
Enfermedades renales
Biopsia
Nefropatías diabéticas
Glomeruloesclerosis focal y segmentaria
Glomerulonefritis por IGA
Nefritis intersticial
Biopsy
Kidney diseases
Diabetic nephropathies
Glomerulosclerosis, focal segmental
Glomerulonephritis, IGA
Nephritis, interstitial
https://id.nlm.nih.gov/mesh/D003920
https://id.nlm.nih.gov/mesh/D001706
https://id.nlm.nih.gov/mesh/D007674
https://id.nlm.nih.gov/mesh/D003928
https://id.nlm.nih.gov/mesh/D005923
https://id.nlm.nih.gov/mesh/D005922
https://id.nlm.nih.gov/mesh/D009395
Rights
embargoedAccess
License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
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oai_identifier_str oai:bibliotecadigital.udea.edu.co:10495/29539
network_acronym_str UDEA2
network_name_str Repositorio UdeA
repository_id_str
dc.title.spa.fl_str_mv Clinical factors associated with non-diabetic renal disease in diabetic latin american patients, histopathological findings, and predictive model
dc.title.alternative.spa.fl_str_mv Factores clínicos asociados a la enfermedad renal no diabética en pacientes diabéticos latinoamericanos, hallazgos histopatológicos y modelo predictivo
title Clinical factors associated with non-diabetic renal disease in diabetic latin american patients, histopathological findings, and predictive model
spellingShingle Clinical factors associated with non-diabetic renal disease in diabetic latin american patients, histopathological findings, and predictive model
Diabetes mellitus
Enfermedades renales
Biopsia
Nefropatías diabéticas
Glomeruloesclerosis focal y segmentaria
Glomerulonefritis por IGA
Nefritis intersticial
Biopsy
Kidney diseases
Diabetic nephropathies
Glomerulosclerosis, focal segmental
Glomerulonephritis, IGA
Nephritis, interstitial
https://id.nlm.nih.gov/mesh/D003920
https://id.nlm.nih.gov/mesh/D001706
https://id.nlm.nih.gov/mesh/D007674
https://id.nlm.nih.gov/mesh/D003928
https://id.nlm.nih.gov/mesh/D005923
https://id.nlm.nih.gov/mesh/D005922
https://id.nlm.nih.gov/mesh/D009395
title_short Clinical factors associated with non-diabetic renal disease in diabetic latin american patients, histopathological findings, and predictive model
title_full Clinical factors associated with non-diabetic renal disease in diabetic latin american patients, histopathological findings, and predictive model
title_fullStr Clinical factors associated with non-diabetic renal disease in diabetic latin american patients, histopathological findings, and predictive model
title_full_unstemmed Clinical factors associated with non-diabetic renal disease in diabetic latin american patients, histopathological findings, and predictive model
title_sort Clinical factors associated with non-diabetic renal disease in diabetic latin american patients, histopathological findings, and predictive model
dc.creator.fl_str_mv Garay Guerrero, Jennifer
Pinilla Sogamoso, Jorge Luis
dc.contributor.advisor.none.fl_str_mv Arias, Luis Fernando
Rodelo Ceballos, Joaquin Roberto
dc.contributor.author.none.fl_str_mv Garay Guerrero, Jennifer
Pinilla Sogamoso, Jorge Luis
dc.subject.mesh.none.fl_str_mv Diabetes mellitus
Enfermedades renales
Biopsia
Nefropatías diabéticas
Glomeruloesclerosis focal y segmentaria
Glomerulonefritis por IGA
Nefritis intersticial
Biopsy
Kidney diseases
Diabetic nephropathies
Glomerulosclerosis, focal segmental
Glomerulonephritis, IGA
Nephritis, interstitial
topic Diabetes mellitus
Enfermedades renales
Biopsia
Nefropatías diabéticas
Glomeruloesclerosis focal y segmentaria
Glomerulonefritis por IGA
Nefritis intersticial
Biopsy
Kidney diseases
Diabetic nephropathies
Glomerulosclerosis, focal segmental
Glomerulonephritis, IGA
Nephritis, interstitial
https://id.nlm.nih.gov/mesh/D003920
https://id.nlm.nih.gov/mesh/D001706
https://id.nlm.nih.gov/mesh/D007674
https://id.nlm.nih.gov/mesh/D003928
https://id.nlm.nih.gov/mesh/D005923
https://id.nlm.nih.gov/mesh/D005922
https://id.nlm.nih.gov/mesh/D009395
dc.subject.meshuri.none.fl_str_mv https://id.nlm.nih.gov/mesh/D003920
https://id.nlm.nih.gov/mesh/D001706
https://id.nlm.nih.gov/mesh/D007674
https://id.nlm.nih.gov/mesh/D003928
https://id.nlm.nih.gov/mesh/D005923
https://id.nlm.nih.gov/mesh/D005922
https://id.nlm.nih.gov/mesh/D009395
description ABSTRACT: The prevalence of diabetes was reported by the World Health Organization from 180 million in 1980 to 422 million in 2014, differentiating those patients who have diabetes. Still, it is not the cause of kidney damage. It is actually in the presence of non-diabetic renal disease (NDRD) or who, in addition to having diabetic nephropathy, simultaneously suffers from another illness that aggravates kidney function and is susceptible to a therapeutic intervention other than glycemic control that allows for improving renal survival. The present analysis of 201 biopsies from native kidneys in diabetes mellitus patients from the pathology department of the University of Antioquia at the San Vicente Hospital clinical laboratory was a retrospective cohort study. The kidney biopsy report that 41% of patients had diabetic nephropathy, 16% mixed, and 43% NDRD, the most frequent histological finding was focal segmental glomerulosclerosis; in the univariate and multivariate analysis, two independent predictors were identified, each year above the mean age (56 years) increases the risk of presenting NDRD (OR, 1.05; 95% CI, 1.02–1.09; p = 0.002) in the KB. The diabetic retinopathy significantly decreases the occurrence of NDRD (OR, 0.23; 95% CI, 0.09–0.60; p = 0.002). Our findings on the potential predictive strategies, the model with the clinical variables age, diabetic retinopathy, and time of diabetes offered the best predictive performance. The area under the discrimination curve was 0.75 (95% CI, 0.67-0.81) with an acceptable Hosmer Lemeshow test, and calibration can be useful when deciding whether to perform a kidney biopsy..
publishDate 2022
dc.date.accessioned.none.fl_str_mv 2022-07-01T16:34:55Z
dc.date.available.none.fl_str_mv 2022-07-01T16:34:55Z
dc.date.issued.none.fl_str_mv 2022
dc.type.spa.fl_str_mv info:eu-repo/semantics/other
dc.type.coarversion.fl_str_mv http://purl.org/coar/version/c_b1a7d7d4d402bcce
dc.type.hasversion.spa.fl_str_mv info:eu-repo/semantics/draft
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dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/COther
dc.type.local.spa.fl_str_mv Tesis/Trabajo de grado - Monografía - Especialización
format http://purl.org/coar/resource_type/c_46ec
status_str draft
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/10495/29539
url http://hdl.handle.net/10495/29539
dc.language.iso.spa.fl_str_mv eng
language eng
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dc.publisher.place.spa.fl_str_mv Medellín - Colombia
institution Universidad de Antioquia
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spelling Arias, Luis FernandoRodelo Ceballos, Joaquin RobertoGaray Guerrero, JenniferPinilla Sogamoso, Jorge Luis2022-07-01T16:34:55Z2022-07-01T16:34:55Z2022http://hdl.handle.net/10495/29539ABSTRACT: The prevalence of diabetes was reported by the World Health Organization from 180 million in 1980 to 422 million in 2014, differentiating those patients who have diabetes. Still, it is not the cause of kidney damage. It is actually in the presence of non-diabetic renal disease (NDRD) or who, in addition to having diabetic nephropathy, simultaneously suffers from another illness that aggravates kidney function and is susceptible to a therapeutic intervention other than glycemic control that allows for improving renal survival. The present analysis of 201 biopsies from native kidneys in diabetes mellitus patients from the pathology department of the University of Antioquia at the San Vicente Hospital clinical laboratory was a retrospective cohort study. The kidney biopsy report that 41% of patients had diabetic nephropathy, 16% mixed, and 43% NDRD, the most frequent histological finding was focal segmental glomerulosclerosis; in the univariate and multivariate analysis, two independent predictors were identified, each year above the mean age (56 years) increases the risk of presenting NDRD (OR, 1.05; 95% CI, 1.02–1.09; p = 0.002) in the KB. The diabetic retinopathy significantly decreases the occurrence of NDRD (OR, 0.23; 95% CI, 0.09–0.60; p = 0.002). Our findings on the potential predictive strategies, the model with the clinical variables age, diabetic retinopathy, and time of diabetes offered the best predictive performance. The area under the discrimination curve was 0.75 (95% CI, 0.67-0.81) with an acceptable Hosmer Lemeshow test, and calibration can be useful when deciding whether to perform a kidney biopsy..RESUMEN: La prevalencia de diabetes fue reportada por la Organización Mundial de la Salud de 180 millones en 1980 a 422 millones en 2014, diferenciando a aquellos pacientes que tienen diabetes. Aún así, no es la causa del daño renal. Es en realidad en presencia de enfermedad renal no diabética (ERND) o que, además de tener nefropatía diabética, padezca simultáneamente otra enfermedad que agrave la función renal y sea susceptible de una intervención terapéutica distinta al control glucémico que permita mejorar la función renal. El presente análisis de 201 biopsias de riñones nativos en pacientes con diabetes mellitus del departamento de patología de la Universidad de Antioquia en el laboratorio clínico del Hospital San Vicente fue un estudio de cohorte retrospectivo. La biopsia renal reportó que el 41% de los pacientes presentaban nefropatía diabética, el 16% mixta y el 43% NDRD, el hallazgo histológico más frecuente fue la glomeruloesclerosis focal y segmentaria; en el análisis univariado y multivariado se identificaron dos predictores independientes, cada año por encima de la edad media (56 años) aumenta el riesgo de presentar ENDR (OR, 1,05; IC 95%, 1,02-1,09; p = 0,002) en la KB. La retinopatía diabética reduce significativamente la aparición de NDRD (OR, 0,23; IC 95 %, 0,09–0,60; p = 0,002). Nuestros hallazgos sobre las posibles estrategias predictivas, el modelo con las variables clínicas edad, retinopatía diabética y tiempo de diabetes ofreció el mejor desempeño predictivo. El área bajo la curva de discriminación fue de 0,75 (IC 95 %, 0,67-0,81) con una prueba de Hosmer Lemeshow aceptable, y la calibración puede ser útil para decidir si se debe realizar una biopsia renal.30application/pdfenginfo:eu-repo/semantics/draftinfo:eu-repo/semantics/otherhttp://purl.org/coar/resource_type/c_46echttp://purl.org/redcol/resource_type/COtherTesis/Trabajo de grado - Monografía - Especializaciónhttp://purl.org/coar/version/c_b1a7d7d4d402bcceinfo:eu-repo/semantics/embargoedAccesshttp://creativecommons.org/licenses/by-nc-nd/2.5/co/http://purl.org/coar/access_right/c_f1cfhttps://creativecommons.org/licenses/by-nc-sa/4.0/Diabetes mellitusEnfermedades renalesBiopsiaNefropatías diabéticasGlomeruloesclerosis focal y segmentariaGlomerulonefritis por IGANefritis intersticialBiopsyKidney diseasesDiabetic nephropathiesGlomerulosclerosis, focal segmentalGlomerulonephritis, IGANephritis, interstitialhttps://id.nlm.nih.gov/mesh/D003920https://id.nlm.nih.gov/mesh/D001706https://id.nlm.nih.gov/mesh/D007674https://id.nlm.nih.gov/mesh/D003928https://id.nlm.nih.gov/mesh/D005923https://id.nlm.nih.gov/mesh/D005922https://id.nlm.nih.gov/mesh/D009395Clinical factors associated with non-diabetic renal disease in diabetic latin american patients, histopathological findings, and predictive modelFactores clínicos asociados a la enfermedad renal no diabética en pacientes diabéticos latinoamericanos, hallazgos histopatológicos y modelo predictivoMedellín - ColombiaEspecializacion en nefrologiaEspecializaciónFacultad de Medicina. Especialización en NefrologíaUniversidad de AntioquiaCC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8823https://bibliotecadigital.udea.edu.co/bitstream/10495/29539/3/license_rdfb88b088d9957e670ce3b3fbe2eedbc13MD53LICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://bibliotecadigital.udea.edu.co/bitstream/10495/29539/7/license.txt8a4605be74aa9ea9d79846c1fba20a33MD57ORIGINALGarayyPinilla_2022_Non-diabeticRenalDisease.pdfGarayyPinilla_2022_Non-diabeticRenalDisease.pdfTrabajo de grado de especializaciónapplication/pdf328531https://bibliotecadigital.udea.edu.co/bitstream/10495/29539/6/GarayyPinilla_2022_Non-diabeticRenalDisease.pdff7a20f9c8ac81747fae2c606593e6208MD5610495/29539oai:bibliotecadigital.udea.edu.co:10495/295392022-07-01 11:36:54.858Repositorio Institucional Universidad de Antioquiaandres.perez@udea.edu.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