Fedulovs, A.; Tzivian, L.; Zalizko, P.; Ivanova, S.; Bumane, R.; Janeviča, J.; Krūzmane, L.; Krustins, E.; Sokolovska, J. Progression of Diabetic Kidney Disease and Gastrointestinal Symptoms in Patients with Type I Diabetes. Biomedicines2023, 11, 2679.
Fedulovs, A.; Tzivian, L.; Zalizko, P.; Ivanova, S.; Bumane, R.; Janeviča, J.; Krūzmane, L.; Krustins, E.; Sokolovska, J. Progression of Diabetic Kidney Disease and Gastrointestinal Symptoms in Patients with Type I Diabetes. Biomedicines 2023, 11, 2679.
Fedulovs, A.; Tzivian, L.; Zalizko, P.; Ivanova, S.; Bumane, R.; Janeviča, J.; Krūzmane, L.; Krustins, E.; Sokolovska, J. Progression of Diabetic Kidney Disease and Gastrointestinal Symptoms in Patients with Type I Diabetes. Biomedicines2023, 11, 2679.
Fedulovs, A.; Tzivian, L.; Zalizko, P.; Ivanova, S.; Bumane, R.; Janeviča, J.; Krūzmane, L.; Krustins, E.; Sokolovska, J. Progression of Diabetic Kidney Disease and Gastrointestinal Symptoms in Patients with Type I Diabetes. Biomedicines 2023, 11, 2679.
Abstract
(1) Background: Little research is done on the link of diabetic kidney disease (DKD) progression and diabetic gastroenteropathy in type 1 diabetes (T1D). (2) Methods. We performed a cross-sectional study with 100 T1D patients, 27 of them had progressive DKD, defined as estimated glomerular filtration rate (eGFR) decline≥3 ml/min/year or increased albuminuria stage over the mean follow-up time of 5.89±1.73 years. Newly developed score with 17 questions on gastrointestinal (GI) symptoms was used. Faecal calprotectin was measured by ELISA. Lower GI endoscopies were performed in 21 patients. (3) Results: Gastrointestinal symptom score demonstrated high reliability (Cronbach's α=0.78). Patients with progressive DKD had higher GI symptom scores compared to those with stable DKD (p=0.019). The former group demonstrated more frequent bowel movement disorders (p=0.04). The scores correlated negatively with eGFR (r = -0.335; p = 0.001), positively with albuminuria (r=0.245; p=0.015), Hba1c (r=0.305, p=0.002), diabetes duration (r=0.251, p=0.012). Faecal calprotectin levels did not differ between DKD groups significantly. The most commonly reported histopathological findings of enteric mucosa were infiltration with eosinophils, lymphocytes, plasmacytes, presence of lymphoid follicles and lymphoid aggregates. Conclusion: progression of DKD positively correlated with gastrointestinal symptoms, but more research is needed to clarify the causal relationships of the gut-kidney axis in T1D.
Keywords
Type 1 diabetes; gastrointestinal symptoms; calprotectin; gastrointestinal endoscopy
Subject
Public Health and Healthcare, Other
Copyright:
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