Translated Abstract
Background:
Diabetic Kidney disease (DKD) is a global public health problem worldwide, the Chief problem has become a hazard to human health, on the life and quality of life for patients is a big problem, but also caused a huge burden to the country. Data showed that early detection, early diagnosis and early intervention treatment is the primary means of preventing diabetic kidney disease. At present, 24 h urine protein quantitative method is more accurate, while the traditional method of the determination of urine proteins, is the gold standard for diagnosis of diabetic kidney disease. But studies have shown that 24-hour urine collection timing inaccuracies, often urine sample collection process for a long time, sample collection and imperfect and incomplete emptying of the bladder, poor patient compliance, 24 h urine sample collected in the younger children is very difficult, urine collection is often inaccurate, affects the accuracy of the results and the results of clinical judgment. To solve these problems, many foreign research shows that urine urine albumin/creatinine ratio in urine as early diagnosis indicators of diabetic kidney disease. However, in early diagnosis of diabetic kidney disease, urine urine albumin/creatinine ratio (ACR) is worth more than a 24-hour urine protein is not clear. This research aims to study the urine urine albumin/creatinine ratio＇s value in early diagnosis of diabetic kidney disease.
Objective:
Study of urine albumin/creatinine ratio in urine in diabetic kidney disease (DKD) value in early diagnosis, and explore urine albumin/creatinine ratio in urine in the morning instead of 24-hour urine protein become the gold standard for diagnosis of early diabetic nephropathy of feasibility, in order to better apply to clinical diagnostics, therapeutic experiments laid the Foundation.
Methods:
1. By collecting the patient age, gender, duration and other relevant clinical information, for general statistical analysis of outcome measures;
2. Pyrogallol red method was used to determine urine protein levels, coupling/sarcosine oxidase end-point method for determination of urinary creatinine, urine ACR calculation;
3. 24-hour urine protein with pyrogallol red method;
4. By double antibody sandwich Elisa method for quantitative determination of albumin in
urine, microalbuminuria is used to calculate the clearance rate (UAER);
5. Quantitative determination of hemoglobin using anion-exchange high performance liquid chromatography, determination of urea by urease, sarcosine oxidase coupled/endpoint method on the content of serum creatinine was measured.
6. Application of SPSS16.0 software for data analysis, measurement data (), with a correlation analysis and non-parametric test rank test.7. determination of urea using urease method;
7. Using sarcosine oxidase coupled/end method to determination of serum creatinine levels;
Based on urinary albumin/creatinine ratio in urine, urine protein results, glycosylated hemoglobin level and duration are grouped, the analysis of the test data.
Result:
1. Diabetic nephrotic group compared with the control group, no significant gender, age (P＞0.05); urine, microalbuminuria is used to calculate the clearance rate (UAER);
2. In diabetic nephropathy, urinary ACR-positive Group (group a),-negative group (Group b) and the healthy control group comparison, ACR, and 24-hour urine protein and UAER in urine in the morning, serum creatinine, blood urea were statistically significant (P＜0.05); Diabetic nephropathy compared group, group a and group b, ACR, and 24-hour urine protein in urine in the morning, were statistically significant between UAER (P＜0.05); Diabetic Kidney disease in the group a and group b, no statistical significance between serum creatinine, blood urea (P＞0.05).
3. Groups of diabetic nephropathy urine ACR and UAER in group a, 24h, urinary protein-positive rate significantly higher than the control group (P＜0.05); Group b ACR, UAER diabetic nephropathy, 24h positive urinary protein was significantly higher than the control group (P＜0.05); Comparison between diabetic nephropathy in groups a, b, ACR, UAER, 24h urine protein in urine positive rate was statistically significant (P＜0.05). UAER, 24h, abnormal urine protein detection rate lags behind ACR.
4. ACR group a and group b urine positive rate comparison was not significant; C-group I urine positive rate of ACR and a group ⅰ, ⅰ b is statistically significant (P＜0.05), urine ACR ratio with increasing HbAlc level also increases.
5. Urine ACR ratio was positively correlated with disease. C ii a, II b and II groups were statistically significant (P＜0.05), b group and a comparison group was statistically significant (P＜0.05).
6. Diabetic urine ACR ratio was significantly higher than the control group (P＜0.05), comparison between ACR ratio in urine in diabetic groups showed significant difference (P＜0.05), diabetic retinopathy and urinary ACR was positively correlated (r = 0.662).
7. All the patients urine ACR was positively correlated with 24 h urine protein (r=0.621).
8. All the patients urine ACR was positively correlated with urinary albumin excretion rate (r=0.711)
Conclusion:
1. Morning urine albumin/creatinine ratio in urine associated with a 24-hour urine protein;
2. 24-hour urine protein and urine albumin/creatinine ratio in urine compared to lag in diagnosis of diabetic kidney disease;
3. Morning urine albumin/creatinine ratio in urine can be used as indicators in early diagnosis of diabetic kidney disease.
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