Critical shear stress of red blood cells as a novel integrated biomarker for screening chronic kidney diseases in cases of type 2 diabetes.
Clin Hemorheol Microcirc
; 81(4): 293-303, 2022.
Article
em En
| MEDLINE
| ID: mdl-35466928
ABSTRACT
BACKGROUND:
The glomerular filtration rate (GFR) and albumin-to-creatinine ratio (ACR) have been widely used to identify and manage diabetic kidney disease (DKD). However, classifications based on these two indices do not always concur in terms of DKD diagnosis; for example, cases of high ACR with normal GFR or normal ACR with low GFR may occur. A recent study suggested that critical shear stress (CSS), a hemorheological parameter to represent aggregating force of red blood cells (RBCs), is a potential screening index for DKD. In the present study, we investigated the diagnostic potential of CSS for DKD according to the KDIGO 2012 Guideline.METHODS:
A total of 378 patients with type 2 diabetes who visited Yeungnam University Hospital between 2014 and 2017 were included. CSS was measured using a transient microfluidic hemorheometer, Rheoscan-D300® (Rheomeditech, Seoul, Republic of Korea) with whole blood. Patients who were DKD negative (green zone) were compared with patients who were DKD positive (red zone) as Model 1 and patients at risk for (orange zone) and red zones as Model 2, respectively.RESULTS:
After exclusion criteria such as eGFRâ<â30âmL/min/1.73âm2, alcoholism, and macrovascular complications were applied, the sensitivity and specificity were 100% and 77.8% for Model 1 and 75.0% and 72.0% for Model 2, respectively. The diagnostic accuracy measures of the CSS for Model 1 were found to be highly accurate or have the potential to alter clinical decisions. Similarly, the diagnostic accuracy measures of CSS for Model 2 were found to provide useful information, despite them expanding to the orange and red zones.CONCLUSION:
DKD was successfully identified using a novel integrated hemorheological index of CSS that satisfied both ACR and GFR criteria. Therefore, CSS may be useful for the additive diagnosis of DKD with GFR and uACR.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Diabetes Mellitus Tipo 2
/
Nefropatias Diabéticas
/
Insuficiência Renal Crônica
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
/
Screening_studies
Limite:
Humans
Idioma:
En
Revista:
Clin Hemorheol Microcirc
Assunto da revista:
ANGIOLOGIA
/
HEMATOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article