Objective: SUDOSCAN (Impeto Medical, Paris, France) has been proved to be a new and non-invasive method in detecting renal dysfunction in type 2 diabetes mellitus (T2DM) patients. In this study, we sought to compare the result of diabetic kidney dysfunction score (DKD-score) of SUDOSCAN with estimated glomerular filtration rate (eGFR) by using quantile regression analysis, which was completely different from previous studies.
Methods: A total number of 223 Chinese T2DM patients were enrolled in the study. SUDOSCAN, renal function test (including blood urea nitrogen, creatinine and uric acid) and 99mTc-diethylenetriamine pentaacetic acid (99mTc-DTPA) renal dynamic imaging were performed in all T2DM patients. DKD-score of SUDOSCAN was compared with eGFR detected by 99mTc-DTPA renal dynamic imaging through quantile regression analysis. Its validation and utility was further determined through bias and precision test.
Results: The quantile regression analysis demonstrated the relationship with eGFR was inverse and significant for almost all percentiles of DKD-score. The coefficients decreased as the percentile of DKD-score increased. And in validation data set, both the bias and precision were increased with the eGFR (median difference, -21.2 ml/min/1.73 m2 for all individuals vs. -4.6 ml/min/1.73 m2 for eGFR between 0 and 59 ml/min/1.73 m2; interquartile range [IQR] for the difference, -25.4 ml/min/1.73 m2 vs. -14.7 ml/min/1.73 m2). The eGFR category misclassification rate were 10% in eGFR 0-59 ml/min/1.73 m2 group, 57.3% in 60-90 group, and 87.2% in eGFR > 90 ml/min/1.73 m2 group.
Conclusion: DKD-score of SUDOSCAN could be used to detect renal dysfunction in T2DM patients. A higher prognostic value of DKD-score was detected when eGFR level was lower.
Keywords: DKD; SUDOSCAN; eGFR.
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