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Edited by Yimaitong, please do not reprint without authorization.
Challenge yourself and accumulate knowledge.
What, another exam? NO! This is just a playoff game.
The Endocrinology Department of Yimaitong has set up a column of "Passing Customs' Secret Language", which aims to help everyone consolidate or update endocrine-related knowledge in a relaxed and pleasant learning atmosphere.
Each issue contains about 5 multiple-choice questions.
The content is mainly based on authoritative guides/consensus at home and abroad.
References will be marked in the analysis part for everyone to review and review.
The content of this quiz is based on the "Chinese Guidelines for Clinical Diagnosis and Treatment of Diabetic Kidney Disease" published in the Chinese Journal of Nephrology in March this year.
Get ready and let's answer the questions together.
True or False Question 1.
Diabetic patients with "non-diabetic nephropathy" are very rare in clinical practice.
A: Right B: Wrong Click on the blank space below to get the answer (slideable) Answer: B Resolution: "Guide" mentions: In the long course of diabetes, patients can have various primary and secondary glomeruli.
Disease or other systemic diseases.
The incidence of NDKD in renal biopsy of diabetic patients is about 10%-85%.
Multiple-choice question 2.
Which of the following situations should be considered for diabetic patients who may have "non-diabetic nephropathy"? A: Angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor antagonist (ARB) drugs have decreased eGFR by more than 30% within 3 months.
B: Suddenly a large number of red blood cells, white blood cells or Cell cast C: The blood pressure continues to be low.
Click on the blank space below to get the answer (slideable) Answer: A, B Analysis: Since the occurrence, development, treatment and prognosis of diabetic nephropathy are completely different from those of non-diabetic nephropathy, the "Guide" suggests that if the patient appears In the following situations, non-diabetic nephropathy may be considered: 1.
The eGFR of DM patients declines rapidly in a short period of time. (B) 2.
During the course of DM, there is no obvious microalbuminuria, or the appearance time is very short, or the proteinuria suddenly increases sharply, or the nephrotic syndrome appears in a short time.
(B) 3.
Urine test indicates "active" urine sediment.
(B) 4.
Intractable hypertension.
(C) 5.
Clinically confirmed patients have primary or secondary glomerular disease or other systemic diseases.
(A) 6.
Angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor antagonist (ARB) class of drugs decreased eGFR by more than 30% within 3 months.
(B) 7.
Imaging revealed that the kidney has structural abnormalities such as stones, cysts, horseshoe kidneys, or a history of kidney transplantation.
(A) 8.
Kidney biopsy reveals the pathological changes of other kidney diseases.
(A) True or False Question 3.
Diabetic retinopathy is an important and necessary basis for the diagnosis of DKD.
A: Yes, B: Wrong, click on the blank space below to get the answer (slideable) Answer: B Analysis: "Guide" points out: Diabetic retinopathy (DR) is one of the important basis for the diagnosis of DKD patients.
If diabetic patients have albuminuria and DR at the same time, it strongly indicates the occurrence of DKD, but it is not a necessary condition for diagnosis, because some patients are not accompanied by retinopathy in the early stage.
Multiple choice question 4.
If the patient's eGFR is 45ml/min/1.
73m^2 and UACR is 500mg/g, what should be the DKD staging? A: G2A3B: G3A3C: G3A2 Click on the blank space below to get the answer (slideable) Answer: B Resolution: The "Guide" recommends the combined evaluation method of eGFR and UACR for clinical staging of DKD. eGFR: ➤G1: ≥90ml/min/1.
73m^2➤G2: 60-89ml/min/1.
73m^2➤G3: 30-59ml/min/1.
73m^2➤G4: 15-29ml/min/1.
73 m^2➤G5: <15ml/min/1.
73m^2UACR: ➤A1: <30mg/g➤A2: 30-300mg/g➤A3:>300mg/g Multiple choice questions 5.
Which of the following occurs, can Consider a kidney biopsy (no contraindications)? A: The patient has a large amount of proteinuria but no DRB: The patient has a large amount of proteinuria or nephrotic syndrome in a short time C: Intractable hypertension Click on the blank space below to get the answer (slideable) Answer: A, B, C Analysis: Kidney biopsy It is of great value for the diagnosis of DKD.
However, the indications of DKD kidney biopsy have not yet reached a unified consensus at home and abroad.
This "Guide" recommends that under the premise of no contraindications to renal biopsy, patients with the following conditions may consider renal biopsy: 1.
Diabetes mellitus <5 years with massive proteinuria or renal insufficiency.
(A) 2.
A large amount of proteinuria or nephrotic syndrome appears in a short period of time.
(A) 3.
Urine sediment indicates "active" glomerular hematuria.
(B) 4.
Unexplained rapid decline in eGFR or eGFR decline by more than 30% within 3 months after ACEI/ARB treatment.
(B) 5.
A lot of proteinuria but no DR.
(A) 6.
Intractable hypertension.
(C) 7.
Have clinical symptoms, signs or laboratory tests of systemic diseases.
(А) 8.
If pathological grading or disease evaluation of DKD is needed, kidney biopsy can be considered as appropriate.
(B) Reference materials: Expert Group of Nephrology Branch of Chinese Medical Association.
Chinese Guidelines for Clinical Diagnosis and Treatment of Diabetic Nephropathy[J].
Chinese Journal of Nephrology, 2021, 37(3): 255-304.
Challenge yourself and accumulate knowledge.
What, another exam? NO! This is just a playoff game.
The Endocrinology Department of Yimaitong has set up a column of "Passing Customs' Secret Language", which aims to help everyone consolidate or update endocrine-related knowledge in a relaxed and pleasant learning atmosphere.
Each issue contains about 5 multiple-choice questions.
The content is mainly based on authoritative guides/consensus at home and abroad.
References will be marked in the analysis part for everyone to review and review.
The content of this quiz is based on the "Chinese Guidelines for Clinical Diagnosis and Treatment of Diabetic Kidney Disease" published in the Chinese Journal of Nephrology in March this year.
Get ready and let's answer the questions together.
True or False Question 1.
Diabetic patients with "non-diabetic nephropathy" are very rare in clinical practice.
A: Right B: Wrong Click on the blank space below to get the answer (slideable) Answer: B Resolution: "Guide" mentions: In the long course of diabetes, patients can have various primary and secondary glomeruli.
Disease or other systemic diseases.
The incidence of NDKD in renal biopsy of diabetic patients is about 10%-85%.
Multiple-choice question 2.
Which of the following situations should be considered for diabetic patients who may have "non-diabetic nephropathy"? A: Angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor antagonist (ARB) drugs have decreased eGFR by more than 30% within 3 months.
B: Suddenly a large number of red blood cells, white blood cells or Cell cast C: The blood pressure continues to be low.
Click on the blank space below to get the answer (slideable) Answer: A, B Analysis: Since the occurrence, development, treatment and prognosis of diabetic nephropathy are completely different from those of non-diabetic nephropathy, the "Guide" suggests that if the patient appears In the following situations, non-diabetic nephropathy may be considered: 1.
The eGFR of DM patients declines rapidly in a short period of time. (B) 2.
During the course of DM, there is no obvious microalbuminuria, or the appearance time is very short, or the proteinuria suddenly increases sharply, or the nephrotic syndrome appears in a short time.
(B) 3.
Urine test indicates "active" urine sediment.
(B) 4.
Intractable hypertension.
(C) 5.
Clinically confirmed patients have primary or secondary glomerular disease or other systemic diseases.
(A) 6.
Angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor antagonist (ARB) class of drugs decreased eGFR by more than 30% within 3 months.
(B) 7.
Imaging revealed that the kidney has structural abnormalities such as stones, cysts, horseshoe kidneys, or a history of kidney transplantation.
(A) 8.
Kidney biopsy reveals the pathological changes of other kidney diseases.
(A) True or False Question 3.
Diabetic retinopathy is an important and necessary basis for the diagnosis of DKD.
A: Yes, B: Wrong, click on the blank space below to get the answer (slideable) Answer: B Analysis: "Guide" points out: Diabetic retinopathy (DR) is one of the important basis for the diagnosis of DKD patients.
If diabetic patients have albuminuria and DR at the same time, it strongly indicates the occurrence of DKD, but it is not a necessary condition for diagnosis, because some patients are not accompanied by retinopathy in the early stage.
Multiple choice question 4.
If the patient's eGFR is 45ml/min/1.
73m^2 and UACR is 500mg/g, what should be the DKD staging? A: G2A3B: G3A3C: G3A2 Click on the blank space below to get the answer (slideable) Answer: B Resolution: The "Guide" recommends the combined evaluation method of eGFR and UACR for clinical staging of DKD. eGFR: ➤G1: ≥90ml/min/1.
73m^2➤G2: 60-89ml/min/1.
73m^2➤G3: 30-59ml/min/1.
73m^2➤G4: 15-29ml/min/1.
73 m^2➤G5: <15ml/min/1.
73m^2UACR: ➤A1: <30mg/g➤A2: 30-300mg/g➤A3:>300mg/g Multiple choice questions 5.
Which of the following occurs, can Consider a kidney biopsy (no contraindications)? A: The patient has a large amount of proteinuria but no DRB: The patient has a large amount of proteinuria or nephrotic syndrome in a short time C: Intractable hypertension Click on the blank space below to get the answer (slideable) Answer: A, B, C Analysis: Kidney biopsy It is of great value for the diagnosis of DKD.
However, the indications of DKD kidney biopsy have not yet reached a unified consensus at home and abroad.
This "Guide" recommends that under the premise of no contraindications to renal biopsy, patients with the following conditions may consider renal biopsy: 1.
Diabetes mellitus <5 years with massive proteinuria or renal insufficiency.
(A) 2.
A large amount of proteinuria or nephrotic syndrome appears in a short period of time.
(A) 3.
Urine sediment indicates "active" glomerular hematuria.
(B) 4.
Unexplained rapid decline in eGFR or eGFR decline by more than 30% within 3 months after ACEI/ARB treatment.
(B) 5.
A lot of proteinuria but no DR.
(A) 6.
Intractable hypertension.
(C) 7.
Have clinical symptoms, signs or laboratory tests of systemic diseases.
(А) 8.
If pathological grading or disease evaluation of DKD is needed, kidney biopsy can be considered as appropriate.
(B) Reference materials: Expert Group of Nephrology Branch of Chinese Medical Association.
Chinese Guidelines for Clinical Diagnosis and Treatment of Diabetic Nephropathy[J].
Chinese Journal of Nephrology, 2021, 37(3): 255-304.
