Diabetic nephropathy. Interrelation of clinical and laboratory parameters in gender and age aspects

THE AIM: to assess the relationship between clinical and laboratory parameters of diabetic nephropathy (DN), considering patients’sex and age. PATIENTS AND METHODS. A retrospective cohort study included patients with DN. Clinical-demographic and laboratory parameters were analyzed based on sex and age group. RESULTS. The mean duration of type 2 diabetes mellitus was 12.5 years (11.7 years in men; 13.1 years in women). A decrease in estimated glomerular filtration rate (eGFR <60 mL/min) was found in 43.6 % of patients. The most common comorbid conditions in DN were hyperglycemia (92.6 %), arterial hypertension (62.9 %), proteinuria (50.7 %), overweight (42.2 %), obesity (31.8 %), anemia (40.9 %), and hypercholesterolemia (44.4 %). Women with DN had significantly higher age, body mass index (BMI), venous blood glucose, and total cholesterol levels, while hemoglobin (Hb), hematocrit (Ht), and red blood cell counts were lower compared to men. The prevalence of anemia in DN patients was 40.9 % (42.9 % in men; 57.1 % in women), with women showing more pronounced reductions in eGFR and erythrocyte morphology alterations. A negative correlation was observed between eGFR and age, BMI, systolic, pulse, and mean arterial pressure (MAP), as well as Hb, Ht, red blood cell counts, and venous blood glucose concentration. In men, eGFR significantly correlated with age, BMI, heart rate, systolic, pulse, and mean arterial pressure, Hb, Ht, red blood cells, mean corpuscular hemoglobin concentration (MCHC), and blood glucose levels. In women, eGFR was associated with age, disease duration, BMI, systolic, diastolic, pulse, and mean arterial pressure, double product (DP), Hb, Ht, red blood cells, and blood glucose levels. Young patients with DN had lower erythrocyte morphology parameters and higher venous blood glucose levels. In younger patients, eGFR significantly correlated with BMI and DP; in middle-aged patients —with hemodynamic parameters, Hb, Ht, red blood cells, and blood glucose levels; and in elderly patients – with disease duration, BMI, systolic, diastolic, and mean arterial pressure, Hb, Ht, red blood cells, and blood glucose levels. CONCLUSION. The obtained data con- firm the presence of diverse associations between clinical and laboratory parameters of DN, depending on sex and age, which may be an important factor in the progression of renal insufficiency.

1. Dedov II, Shestakova MV, Vikulova OK, et al. Atlas of the diabetes register of the Russian Federation. Status of 2018. Sakharnyy diabet 2019;2S(22):4–61. (In Russ.)

2. Smirnov AV, Dobronravov VA, Kisina AA, et al. Clinical practice guideline for diagnostics and treatment of diabetic nephropathy. Nephrology (Saint-Petersburg) 2015;19(1):67–77. (In Russ.)

3. Sun H, Saeedi P, Karuranga S et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract 2022 Jan;183:109119. https://doi.org/10.1016/j.diabres.2021.109119

4. Gu X, Zhang D, Jiang S, Li W. Crescents and CKD progression in diabetic nephropathy. Med Clin (Barc). 2025 Jan 28:S0025-7753(24)00735-8. English, Spanish. https://doi.org/10.1016/j.medcli.2024.11.007

5. Tomilina NA et al. Chronic kidney disease. Selected chapters of nephrology. GEOTAR-Media, Moscow, 2017, T.136. (In Russ.)

6. Murkamilov IT, Aitbaev KA, Fomin VV. Prevalence, age and gender features of chronic kidney disease in patients with diabetes mellitus. Terapevticheskii arkhiv 2023;95:6:481–486. (In Russ.) https://doi.org/10.26442/00403660.2023.06.202242

7. Murkamilov IT, Aitbaev KA, Fomin VV et al. Diabetic nephropathy: prevalence and risk factors. Journal of Volgograd State Medical University 2021;1(77):3–11. (In Russ.) https://doi.org/10.19163/1994-9480-2021-1(77)-3-11

8. Bobkova IN, Shestakova MV, Schukina AA. Diabetic nephropathy – focus on podocytes damage. Nephrology (Saint-Petersburg) 2015;19(2):33–44. (In Russ.)

9. Bobkova IN, Shchukina A, Shestakova MV. Assessment of nephrin and podocin levels in the urine of patients with diabetes mellitus. Nephrology (Saint-Petersburg) 2017;21(2):33–40. (In Russ.) https://doi.org/10.24884/1561-6274-2017-21-2-33-40

10. Sun T, Guo Y, Su Y et al. Molecular mechanisms of diabetic nephropathy: A narrative review. Cell Biol Int 2024;48(9):1240–1253. https://doi.org/10.1002/cbin.12212

11. Dwivedi S, Sikarwar MS. Diabetic Nephropathy: Pathogenesis, Mechanisms, and Therapeutic Strategies. Horm Metab Res 2025; 57(1):7–17. https://doi.org/10.1055/a-2435-8264

12. Thomas MC, Weekes AJ, Broadley OJ, Cooper ME. The assessment of kidney function by general practitioners in Australian patients with type 2 diabetes (NEFRON-2). Med J Aust 2006 Sep 4;185(5):259–262. https://doi.org/10.5694/j.1326-5377.2006.tb00556.x

13. Selikhanova VM, Isayeva KhT, Arshidinova KM et al. Diabetic nephropathy: analysis of risk factors affecting the development of chronic kidney disease in diabetes melius. Medicine and ecology 2021;(2):75–79. (In Russ.)

14. Boriskina OL, Tsigan VN, Rumyantsev AS, Yakovenko AA. The role of advanced glycation end products in sarcopenia in CKD patients. Nephrology (Saint-Petersburg) 2023;27(4):43–51. (In Russ.) https://doi.org/10.36485/1561-6274-2023-27-4-43-51

15. Rumyantsev ASh, Shishkin AN, Minkin SR, Sheveleva MA. Features of cardiorenal relationships in patients with metabolic syndrome. Nephrology (Saint-Petersburg) 2016;20(5):75–83. (In Russ.)

16. Pyatchenkov MO, Rumyantsev ASh, Zakharov MV et al. Lipoprotein(a) and kidney diseases. Nephrology (Saint-Petersburg) 2021;25(1):31–46. (In Russ.) https://doi.org/10.36485/1561-6274-2021-25-1-31-46

17. Vorontsov AV, Shestakova MV. Diabetic nephropathy: Pathogenesis and treatment. Problems of Endocrinology 1996;42(4):37– 42. (In Russ.) https://doi.org/10.14341/probl12076

18. Zhang X, Zhou CG, Ma LJ. Role of GDF-15 in diabetic nephropathy: mechanisms, diagnosis, and therapeutic potential. Int Urol Nephrol 2025;57(1):169–175. https://doi.org/10.1007/s11255-024-04179-2

19. Borisov AG, Chernavskiy SV, Smirnova MA, Stremoukhov AA. Diabetic nephropathy: modern principles of classification, diagnosis and features of antihyperglycemic therapy. Lechaschy Vrach 2021;9(24):53–58. (In Russ.) https://doi.org/10.51793/OS.2021.24.9.01

20. Shestakova MV, Shamkhalova MSh, Yarek-Martynova IYa, Klefortova II, Sukhareva OYu, Vikulova OK, Zaytseva NV, Martynov SA, Kvaratskheliya MV, Tarasov EV, Trubitsyna NP. Diabetes mellitus and chronic kidney disease: achievements, unresolved problems, and prospects for therapy. Diabetes mellitus 2011;14(1):81–88. (In Russ.) https://doi.org/10.14341/2072-0351-6254

21. Ermolenko VM. Lipoprotein dysfunction in patients with chronic kidney disease (CKD). Pathogenesis and treatment of CKD dyslipidemia (literature review). Nephrology (Saint-Petersburg) 2024;28(1):13–29. (In Russ.) https://doi.org/10.36485/1561-6274-2024-28-1-13-29

22. Shestakova MV, Vikulova OK, Zheleznyakova AV et al. Diabetes mellitus in the elderly: clinical and epidemiological characteristics of the all-Russian cohort of diabetic patients over 65 years. Diabetes mellitus 2024;27(6):504–519. (In Russ.) https://doi.org/10.14341/DM13261