Article ; Online: Electrochemical Skin Conductance in Diabetic Kidney Disease.
American journal of nephrology
2015 Volume 41, Issue 6, Page(s) 438–447
Abstract: Background: There is a need to identify patients with diabetic kidney disease (DKD) using noninvasive, cost-effective screening tests. Sudoscan®, a device using electrochemical skin conductance (ESC) to measure sweat gland dysfunction, is valuable for ... ...
| Abstract | Background: There is a need to identify patients with diabetic kidney disease (DKD) using noninvasive, cost-effective screening tests. Sudoscan®, a device using electrochemical skin conductance (ESC) to measure sweat gland dysfunction, is valuable for detecting peripheral neuropathy. ESC was tested for association with DKD (estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2)) in 383 type 2 diabetes mellitus (T2D)-affected patients; diagnostic thresholds were determined in 540 patients. Methods: Relationships between ESC with eGFR and urine albumin:creatinine ratio (UACR) were assessed in 202 European Americans and 181 African Americans with T2D. Results: In 92 European American DKD cases and 110 T2D non-nephropathy controls, respectively, mean (SD) ages were 69 (9.7) and 61 (10.8) years, hemoglobin A1c (HbA1c) 7.4 (1.2) and 7.4 (1.3)%, eGFR 29.6 (12.2) and 87.8 (14.2) ml/min/1.73 m(2), and UACR 1,214 (1,705) and 7.5 (5.8) mg/g. In 57 African American cases and 124 controls, respectively, mean (SD) ages were 64.0 (11.9) and 59.5 (9.7) years, HbA1c 7.4 (1.3) and 7.5 (1.7)%, eGFR 29.6 (13.3) and 90.2 (16.2) ml/min/1.73 m(2), and UACR 1,172 (1,564) and 7.8 (7.1) mg/g. Mean (SD) ESC (μS) was lower in cases than controls (European Americans: case/control hands 49.5 (18.5)/62.3 (16.2); feet 62.1 (17.9)/73.6 (13.8), both p < 1.3 × 10(-6); African Americans: case/control hands 39.8 (19.0)/48.5 (17.1); feet 53.2 (21.3)/63.5 (19.4), both p ≤ 0.01). Adjusting for age, sex, body mass index and HbA1c, hands and feet ESC associated with eGFR <60 ml/min/1.73 m(2) (p ≤ 7.2 × 10(-3)), UACR >30 mg/g (p ≤ 7.0 × 10(-3)), UACR >300 mg/g (p ≤ 8.1 × 10(-3)), and continuous traits eGFR and UACR (both p ≤ 5.0 × 10(-9)). HbA1c values were not useful for risk stratification. Conclusions: ESC measured using Sudoscan® is strongly associated with DKD in African Americans and European Americans. ESC is a useful screening test to identify DKD in patients with T2D. |
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| MeSH term(s) | African Americans ; Aged ; Albuminuria/urine ; Case-Control Studies ; Creatinine/urine ; Diabetes Mellitus, Type 2/physiopathology ; Diabetic Nephropathies/diagnosis ; Diabetic Nephropathies/physiopathology ; Diabetic Nephropathies/urine ; European Continental Ancestry Group ; Female ; Foot ; Galvanic Skin Response ; Glomerular Filtration Rate ; Glycated Hemoglobin A/metabolism ; Hand ; Humans ; Male ; Middle Aged ; Sweat Glands/physiopathology |
| Chemical Substances | Glycated Hemoglobin A ; hemoglobin A1c protein, human ; Creatinine (AYI8EX34EU) |
| Language | English |
| Publishing date | 2015 |
| Publishing country | Switzerland |
| Document type | Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 604540-6 |
| ISSN | 1421-9670 ; 0250-8095 |
| ISSN (online) | 1421-9670 |
| ISSN | 0250-8095 |
| DOI | 10.1159/000437342 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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