Open AccessDecreased microcirculatory function measured by perfusion index is a novel indicator of diabetic kidney disease in patients with type 2 diabetes
Author(s) -
Okada Hiroshi,
Tanaka Muhei,
Yasuda Takashi,
Okada Yuki,
Norikae Hisahiro,
Fujita Tetsuya,
Nishi Takashi,
Oyamada Hirokazu,
Yamane Tetsuro,
Fukui Michiaki
Publication year - 2020
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.13193
Subject(s) - medicine , renal function , diabetes mellitus , albuminuria , kidney disease , type 2 diabetes , blood pressure , odds ratio , microcirculation , cardiology , kidney , urology , endocrinology
Aims/Introduction Diabetic kidney disease has been considered as an important risk factor of cardiovascular disease. Chronic hypoxia is considered to be the main cause of renal injury. Diminished microcirculatory blood flow could be associated with hypoxia in the kidney. Whether diminished microcirculation is associated with diabetic kidney disease has not yet been reported. Here, we investigated the correlation between microcirculatory function and diabetic kidney disease in patients with type 2 diabetes. Materials and Methods Our cross‐sectional study included 574 patients who were admitted to Matsushita Memorial Hospital in Moriguchi, Japan, for type 2 diabetes. Microcirculatory function was assessed using the perfusion index (PI), which represents the level of circulation through peripheral tissues. We measured the PI for all patients. Results The median age and PI values were 70 years (range 60–77 years) and 2.8% (range 1.6–4.8%). Multiple regression analyses showed that the PI independently correlated with the logarithm of urinary albumin excretion ( P = 0.009) and estimated glomerular filtration rate ( P = 0.005), respectively. Multiple logistic regression analyses showed that patients with systolic blood pressure (SBP) greater than the median and PI less than or equal to the median (high‐low group) had a significantly increased odds of albuminuria compared with those with SBP less than or equal to the median and PI greater than the median (low‐high group), and patients with SBP greater than the median and PI less than or equal to the median (high‐low group) had a significantly increased odds of estimated glomerular filtration rate <60 mL/min per 1.73 m 2 compared with those with SBP less than or equal to the median and PI greater than the median (low‐high group) or SBP greater than the median and PI greater than the median (high‐high group). Conclusions PI could be a novel indicator of diabetic kidney disease in patients with type 2 diabetes.