Glucocorticoid does not improve the renal prognosis of patients with diabetic nephropathy combined with acute tubulointerstitial nephritis: a retrospective analysis

Figures & data

Figure 1. Flow chart of the study population.

Table 1. Baseline characteristics of patients with DN combined with ATIN.

Variable	Group		χ^2/t	p
	Non-steroid	Steroid
Gender(%)
Male	22(64.7)	29(87.88)	4.947	0.026
Female	12(35.2)	4(12.12)
Age(years)	52.82 ± 9.85	50.48 ± 11.48	0.896	0.374
BMI	26.69 ± 2.99	27.56 ± 4.09	−0.999	0.321
Hypertension(%)
No	1(2.94)	2(6.06)	0.381	0.537
Yes	33(97.0)	31(93.94)
Diabetic retinopathy(%)
No	16(47.0)	11(33.33)	1.311	0.252
Yes	18(52.9)	22(66.67)
Hyperlipemia(%)
No	13(38.2)	13(39.39)	0.009	0.922
Yes	21(61.7)	20(60.61)
Glomerular pathology grading(%)
I	0(0.00)	1(3.03)	2.016	0.733
IIa	2(5.88)	2(6.06)
IIb	6(17.65)	6(18.18)
III	24(70.5)	20(60.61)
IV	2(5.88)	4(12.12)
IFTA(%)
None	0(0.00)	0(0.00)	0.457	0.796
Mild	3(8.82)	2(6.06)
Moderate	20(58.8)	18(54.55)
Severe	11(32.3)	13(39.39)

Table 2. Changes in Laboratory Indicators of patients with DN combined with ATIN.

	Non-steroid Group		Steroid Group
	baseline	follow-up	baseline	follow-up
SCr(umol/)	172.0 (106.4,247.4)	218.2 (121.4,380.1)^a	232.2 (151.8,353.8)^b	311.8 (198.9,563.1)^ac
eGFR	38.8(21.9,61.0)	26.1(15.1,47.7)^a	27.8(14.6,45.4)	20.1(10.0,30.3)^ac
Serum albumin (g/L)	33.7(28.5,39.0)	34.2(29.3,36.3)	31.4(28.3,37.0)	31.0(28.5,35.2)
24-h Urinary protein (g)	5.2(2.5,6.9)	3.5(1.7,5.3)^a	7.3(3.9,10.7)^b	5.9(3.5,7.9)^ac
Urinary red blood cell (/HP)	3.2(1.3,5.0)	2.6(1.3,3.2)	4.6(2.5,8.8)b	2.3(1.2,3.2)^a
Eos(*10^9/L)	0.2(0.1,0.3)	0.1(0.1,0.3)	0.2(0.1,0.3)	0.2(0.1,0.3)
Eos%(%)	2.5(1.6,4.5)	2.3(1.3,3.8)	2.1(1.0,3.3)	1.7(0.8,3.3)
HGB(g/L)	112.0 (102.3,124.5)	120.0 (100.3,125.0)	106.0 (89.0,110.0)^b	105.0 (92.0,116.0)^c
TC(mmol/)	5.4(4.7,6.4)	4.4(3.5,5.7)^a	4.9(3.6,5.5)^b	5.2(3.6,6.3)
TG(mmol/)	1.9(1.3,3.1)	1.6(1.2,2.1)	1.6(1.1,2.5)	1.8(1.3,2.5)
UA(umol/)	402.0 (358.0,488.8)	384.5 (344.5,407.5)^a	430.0 (361.0,474.0)	425.0 (379.0,477.0)^c
HbA1c(%)	7.4(6.5,8.0)	6.7(6.0,7.0)^a	6.9(6.1,7.6)	6.8(6.3,7.4)

^aCompared with the baseline of the same group, p < 0.05;

^bComparison between groups at baseline, p < 0.05;

^cComparison between groups at the end of follow-up, p < 0.05.

Abbreviations: SCr: Serum Creatinine; Eos: eosinoph; HGB: hemoglobin; TC: total cholesterol; TG: triglycerides; UA: uric acid; HbA_1c: glycated hemoglobin.

Table 3. Complications and prognosis of patients with DN combined with ATIN at the end of follow-up.

Variable	Group		χ^2	p
	Non-steroid	Steroid
Infection (%)
No	34(100.00)	30(90.91)	3.236	0.072
Yes	0(0.00)	3(9.09)
Gastrointestinal symptom (%)
No	34(100.00)	32(96.97)	1.046	0.306
Yes	0(0.00)	1(3.03)
Increased blood glucose (%)
No	34(100.00)	21(63.64)	15.061	<0.001
Yes	0(0.00)	12(36.36)
Abnormal blood pressure (%)
No	34(100.00)	25(75.76)	9.36	0.002
Yes	0(0.00)	8(24.24)
Neuropsychiatric symptoms (%)
No	34(100.00)	32(96.97)	1.046	0.306
Yes	0(0.00)	1(3.03)
Renal endpoint event (%)
No	24(70.59)	14(42.42)	4.325	0.038
Yes	10(29.41)	19(57.58)

Table 4. Univariate COX regression analysis of renal endpoint event in patients with DN combined with ATIN.

Variable	p	HR	HR(95% CI)
Gender	0.562	0.766	0.312–1.883
Age	0.711	1.006	0.973–1.041
BMI	0.566	1.028	0.936–1.129
Hypertension	0.858	1.2	0.163–8.819
Diabetic retinopathy	0.167	1.743	0.793–3.829
Hyperlipemia	0.273	1.554	0.707–3.416
SCr	<0.001	1.008	1.005–1.011
eGFR	<0.001	0.932	0.904–0.962
Serum albumin	0.003	0.919	0.869–0.973
24-h urinary protein	0.002	1.093	1.033–1.155
Urinary red blood cell	0.885	1.004	0.946–1.066
Eos	0.632	0.604	0.077–4.76
Eos%	0.464	0.941	0.8–1.107
HGB	0.001	0.964	0.942–0.985
TC	0.181	1.116	0.95–1.31
TG	0.04	1.12	1.005–1.249
UA	0.869	1	0.996–1.004
HbA1c	0.193	0.828	0.623–1.1
Glucocorticoid	0.019	2.507	1.164–5.401

Abbreviations: SCr: serum creatinine; Eos: eosinoph; HGB: hemoglobin; TC: total cholesterol; TG: triglycerides; UA: uric acid; HbA_1c: glycated hemoglobin.

Figure 2. Multivariate COX regression analysis of renal end-point events in patients with DN combined with ATIN.

Abbreviations: SCr: serum creatinine; HGB: hemoglobin; TG: triglycerides.