Abstract
The purpose of this study was to analyze the incidence and precipitating factors of diabetic nephropathy, and the mutual relations among the precipitating factors in terms of clinico-laboratory variables.
Canonical correlation analysis was applied to the clinico-laboratory and patho-histological variables in 40 cases whose patho-histological changes were already known from biopsy or autopsy.
Testing of the accuracy of estimation was carried out in the 40 cases and resulted in a 90.0% coincidence between the estimated patho-histological changes of renal glomeruli based on the clinicolaboratory data and the patho-histological changes.
An investigation of the rates of coincidence in the 40 cases was carried out with the following criteria.
A: only slight “diffuse” changes
B: moderate diffuse changes
C: slight “nodular” changes with moderate or marked diffuse changes
D: marked diffuse changes with moderate or marked nodular changes
In an attempt to reevaluate the present treatment of diabetic nephropathy, the influence of correcting the 5 clinically controllable variables out of the 11 variables adopted for patho-histological changes of the renal glomeruli, was studied by the Marcov process in 220 diabetic outpatients.
The results of this analysis in patients remaining in poorly controlled states for years revealed a tendency for devastating lesions of the nodular type.
With the Marcov process control of blood glucose, blood pressure and the obesity index showed some relation to the development and/or progress of the glomerular changes.
It is concluded that correction of these factors, especially those which can be readily controlled by daily clinical practice, should be attempted to prevent and/or stop development of the diabetic nephropathy.
