Changes of glomerular filtration rate in different stages of patientswith diabetic nephropathy and its influence factors

Objective To evaluate the changes of glomerular filt ration rate (GFR) in patients with different stages of diabetic nephropathy (DN ) and analyse the influence factors of GFR. Methods Using 99m Tc-DTPA , the GFR of 216 2-type diabetes were measured. According to urinary albumin ex cretion rate (UAER ) and blood creatinine, the DN patients were divided into four stages. Results Along with the developing of DN, the patients' GFR decreased ( from 84.0±18.7 t o 79.0±21.0，69.0±15.9，53.7±18.2ml/min) and their UAER increased( from 4.5± 2.4 to 94.0±57.9，314.0±604.3，724.0±923.8μg/min) continuously in different DN stages. A significant negative correlation was found between GFR and UAER (r = - 0.5070, P ＜0.001). In each DN stage, GFR of patients with hypertension w as lower than that without hypertension (76.3±17.4 vs 84.9±18.7, 67.9±22.9 vs 82.1±19.6, 55.7±17.2 vs 69.2±12.0, 47.5±17.2 vs 57.7±17.9 ml/min, all P ＜0.05). GFR in stage-Ⅱ of DN patients with GHbA1c ≥10.0% were higher than that with GHbA1c＜10.0% (86.0±20.6 vs 73.3±19.8 ml/min, P ＜0.05 ). Backward regression analysis was performed. It was shown that only age and sy stolic blood pressure were independently negative correlated with GFR (β=－0.56 ， P ＜0.05；β=－0.28， P ＜0.05). Conclusion GFR was the sensitive indicat or represents glomerular filtration rate in patient with different DN stages. D N patients must strictly controlled blood glucose and blood pressure in order to delay the decrease of GFR.