The Clinical Utility of SUDOSCAN in Chronic Kidney Disease in Chinese Patients with Type 2 Diabetes.
There are gaps between recommendations on regular screening for diabetic kidney disease (DKD) and clinical practice especially in busy and low resource settings. SUDOSCAN (Impeto Medical, Paris, France) is a non-invasive technology for assessing sudomotor function using reverse iontophoresis and chronoamperometry which detects abnormal sweat gland function. Vasculopathy and neuropathy share common risk factors and we hypothesized that SUDOSCAN may be used to detect chronic kidney disease (CKD). Between 2012 and 2013, SUDOSCAN was performed in a consecutive cohort of 2833 Hong Kong Chinese adults with type 2 diabetes. Chronic kidney disease was defined as estimated glomerular filtration rate <60 ml/min/1.73m2. In this cross-sectional cohort (mean age 58.6±9.5 years, 55.7% male, median disease duration 8 [interquartile range 3-14] years), 5.8% had CKD. At a cut-off SUDOSCAN-DKD score of 53, the test had sensitivity of 76.7%, specificity of 63.4% and positive likelihood ratio of 2.1 to detect CKD. The area under receiver operating characteristic curve for CKD was 0.75 (95% confidence interval 0.72-0.79). Patients without CKD but low score had worse risk factors and complications than those with high score. We conclude that SUDOSCAN may be used to detect patients at risk of impaired renal function as part of a screening program in Chinese population, especially in outreach or low resource settings.
Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong, SAR; Hong Kong Institute of Diabetes and Obesity, Prince of Wales Hospital, Hong Kong, SAR; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR; International Diabetes Centre of Education, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR.
Andrea O Y
AO
Luk
Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong, SAR.
Wai-Chi
WC
Fu
Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong, SAR.
Xue
X
Li
Hong Kong Institute of Diabetes and Obesity, Prince of Wales Hospital, Hong Kong, SAR; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR; International Diabetes Centre of Education, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR.
Risa
R
Ozaki
Hong Kong Institute of Diabetes and Obesity, Prince of Wales Hospital, Hong Kong, SAR.
Harriet H Y
HH
Chung
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR; International Diabetes Centre of Education, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR.
Rebecca Y M
RY
Wong
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR; International Diabetes Centre of Education, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR.
Wing-Yee
WY
So
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR; International Diabetes Centre of Education, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR.
Francis C C
FC
Chow
Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong, SAR; Hong Kong Institute of Diabetes and Obesity, Prince of Wales Hospital, Hong Kong, SAR; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR; International Diabetes Centre of Education, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR.
Juliana C N
JC
Chan
D000368:Aged; D019540:Area Under Curve; D002681:China; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000503:physiopathology; D042241:Early Diagnosis; D005260:Female; D005712:Galvanic Skin Response; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000503:physiopathology; D013545:Sweat Glands / Q000503:physiopathology*