Association between the urinary decoy receptor 2-to-creatinine ratio and kidney prognosis in patients with diabetic kidney disease

@article{huanhuan2026association,
  title = {{Association between the urinary decoy receptor 2-to-creatinine ratio and kidney prognosis in patients with diabetic kidney disease}},
  author = {Sun Huan-huan and Sun Ye-zi and Shen Li-min and Zhou Ji},
  journal = {Linchuang shenzangbing zazhi},
  year = {2026},
  month = oct,
  url = {http://www.lcszb.com/thesisDetails#10.3969/j.issn.1671-2390.2026.10.008},
  note = {CC BY-NC-ND},
}

TY  - JOUR
TI  - Association between the urinary decoy receptor 2-to-creatinine ratio and kidney prognosis in patients with diabetic kidney disease
AU  - Sun Huan-huan
AU  - Sun Ye-zi
AU  - Shen Li-min
AU  - Zhou Ji
PY  - 2026
DA  - 2026/10/24
JO  - Linchuang shenzangbing zazhi
UR  - http://www.lcszb.com/thesisDetails#10.3969/j.issn.1671-2390.2026.10.008
AB  - ObjectiveTo investigate the predictive value of the urinary decoy receptor 2 （DcR2）-to-creatinine （Cr） ratio for kidney prognosis in patients with diabetic kidney disease （DKD）.MethodsA retrospective study was conducted. A total of 128 patients with DKD treated at the Zhangjiagang Hospital Affiliated to Soochow University （Zhangjiagang First People’s Hospital） from February 2022 to January 2025 were included. The urinary DcR2/Cr ratio was measured， and based on the Youden index （380.00 ng/g Cr）， patients were divided into a low-level group （n=61） and a high-level group （n=67）. General data were collected， including age， sex， duration of diabetes， blood pressure， blood glucose， blood lipids， and renal function indicators， and were compared between the two groups. All patients received routine interventions during hospitalization. After discharge， patients were followed up for 6 months， and the occurrence of adverse kidney prognosis events was recorded. According to whether adverse kidney prognosis events occurred during follow-up， patients were divided into a kidney prognosis-poor group and a kidney prognosis-good group. Overall survival （OS） was calculated， and survival curves were drawn using the Kaplan-Meier method； survival analysis was performed with the Log-rank test. Cox proportional hazards regression was used to identify independent risk factors for adverse kidney prognosis events in DKD patients. Spearman correlation analysis was used to assess correlations between each indicator and prognosis.ResultsThere were no statistically significant differences between the two groups in age， sex， body mass index， smoking history， and drinking history （P>0.05）. The high-level group had longer duration of diabetes （11.00 ［9.00， 13.00］ years vs 8.00 ［6.00， 10.00］ years）， higher fasting blood glucose （8.50 ［7.50， 9.50］ mmol/L vs 7.25 ［6.50， 8.00］ mmol/L）， higher glycated hemoglobin A1c （HbA1c） （9.00 ［8.00， 9.80］% vs 7.80 ［7.00， 8.50］%）， higher total cholesterol （5.20 ［4.50， 5.80］ mmol/L vs 4.50 ［4.00， 5.00］ mmol/L）， higher triglycerides （2.20 ［1.80， 2.80］ mmol/L vs 1.60 ［1.20， 2.00］ mmol/L）， higher serum creatinine （Scr） （110.00 ［90.00， 130.00］ μmol/L vs 75.00 ［60.00， 90.00］ μmol/L）， higher blood urea nitrogen （BUN） （8.00 ［7.00， 9.50］ mmol/L vs 6.00 ［5.00， 7.00］ mmol/L）， higher uric acid （400.00 ［360.00， 450.00］ μmol/L vs 320.00 ［280.00， 360.00］ μmol/L）， and higher uDcR2/Cr （785.40 ［682.15， 865.22］ ng/g Cr vs 372.15 ［310.62， 425.38］ ng/g Cr） （P<0.05）. The high-level group had lower high-density lipoprotein cholesterol （0.90 ［0.80， 1.05］ mmol/L vs 1.10 ［0.95， 1.25］ mmol/L）， lower albumin （Alb） （36.00 ［34.00， 38.00］ g/L vs 40.00 ［38.00， 42.00］ g/L）， and lower estimated glomerular filtration rate （65.00 ［50.00， 80.00］ mL·min⁻¹·［1.73 m²］⁻¹ vs 90.00 ［75.00， 105.00］ mL·min⁻¹·［1.73 m²］⁻¹） （P<0.05）. During the 6-month follow-up， 45 of 128 patients （35.16%） experienced adverse kidney prognosis events， and 83 patients （64.84%） had good prognosis. In the low-level group， 12 patients （19.67%） had adverse kidney prognosis events and 49 patients （80.33%） had good prognosis， with an OS time of 4 （1， 6） months. In the high-level group， 33 patients （49.25%） had adverse kidney prognosis events and 34 patients （50.75%） had good prognosis， with an OS time of 2 （1， 4） months. The incidence of adverse kidney prognosis events in the low-level group was significantly lower than that in the high-level group （χ²=36.459， P<0.001）. Compared with the kidney prognosis-good group， the kidney prognosis-poor group had higher HbA1c （8.89 ［7.40， 10.60］% vs 8.06 ［6.82， 9.80］%）， Scr （128 ［101， 138］ μmol/L vs 124 ［98， 135］ μmol/L）， BUN （8.82 ［7.65， 9.07］ mmol/L vs 6.74 ［4.58， 7.34］ mmol/L）， and a higher proportion of uDcR2/Cr ≥380.00 ng/g Cr （33/45 vs 34/83） （P<0.05）. Cox regression analysis showed that uDcR2/Cr ratio ≥380.00 ng/g Cr， elevated HbA1c， increased Scr， and increased BUN were risk factors for adverse kidney prognosis events in DKD patients （P<0.05）. Spearman rank correlation analysis showed that adverse kidney prognosis in DKD patients was positively correlated with uDcR2/Cr ratio， HbA1c， Scr， and BUN （P<0.05）.ConclusionThe urinary DcR2/Cr ratio is an independent predictor of kidney prognosis in DKD patients. An increased ratio indicates a higher risk of poor prognosis. When the urinary DcR2/Cr ratio is ≥380.00 ng/g Cr， enhanced clinical monitoring and intervention should be implemented. This biomarker， combined with traditional risk factors， can improve the accuracy of kidney prognosis assessment in DKD patients.
SN  - 1671-2390
ER  -