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. 2015 Aug 13;10(8):e0134981.
doi: 10.1371/journal.pone.0134981. eCollection 2015.

The Clinical Utility of SUDOSCAN in Chronic Kidney Disease in Chinese Patients with Type 2 Diabetes

Andrea O Y Luk  1 , Wai-Chi Fu  2 , Xue Li  2 , Risa Ozaki  3 , Harriet H Y Chung  4 , Rebecca Y M Wong  5 , Wing-Yee So  5 , Francis C C Chow  5 , Juliana C N Chan  1
Affiliations

The Clinical Utility of SUDOSCAN in Chronic Kidney Disease in Chinese Patients with Type 2 Diabetes

Andrea O Y Luk et al. PLoS One. .

Abstract

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.

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Conflict of interest statement

Competing Interests: Pertaining to the SUDOSCAN which is a patented device (details of the patency: Système et procédé d'analyse électrophysiologique / Electrophysiological analysis system and method Publication et délivrance brevet européen : 12/03/2014 Bulletin 2014/11 N° Publication internationale : WO 2006/136598 PCT Chine publication 20/08/2008 délivrance 20/07/2011 CN 101247759A, PCT USA publication 31/12/2009 US-2009-0326407-A),neither my co-authors or myself (Andrea Luk) have any financial or non-financial competing interests related to this patency, and does not alter our adherence to all PLOS ONE policies on sharing data and materials. Pertaining to receipt of funding from Merck Limited, myself (Andrea Luk) have received research grant and travel grants and honoraria for speaking at a meeting sponsored by Merck Limited, and my co-author Prof Juliana Chan has received research grant and travel grants and honoraria for speaking at meetings and for consultancy. Merck Limited has no role in the study design, collection of data, analysis and interpretation of data, paper writing or decision to submit for publication. The receipt of funding from Merck Limited does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Scatterplot showing the relationship between SUDOSCAN-DKD score on y-axis and estimated glomerular filtration rate on x-axis.
Fig 2
Fig 2. Receiver operating characteristic curve of SUDOSCAN-DKD score in detecting chronic kidney disease in Chinese patients with type 2 diabetes
See this image and copyright information in PMC

References

    1. Foley RN, Murray AM, Li S, Herzog CA, McBean AM, Eggers PW, et al. Chronic kidney disease and the risk for cardiovascular disease, renal replacement, and death in the United States Medicare population, 1998 to 1999. J Am Soc Nephrol. 2005;16: 489–495. - PubMed
    1. Tonelli M, Wiebe N, Culleton B, House A, Rabbat C, Fok M, et al. Chronic kidney disease and mortality risk: a systematic review. J Am Soc Nephrol. 2006;17: 2034–2047. - PubMed
    1. Whaley-Connell A, Sowers JR, McCullough PA, Roberts T, McFarlane SI, Chen SC, et al. Diabetes mellitus and CKD awareness: The Kidney Early Evaluation Program (KEEP) and National Health and Nutrition Examination Survey (NHANES). Am J Kidney Dis. 2009;53(Suppl 4): S11–S21. - PubMed
    1. American Diabetes Association. Standards of Medical Care in Diabetes– 2014. Diabetes Care. 2014; 37:S14–S80. 10.2337/dc14-S014 - DOI - PubMed
    1. Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008; 358:580–591. 10.1056/NEJMoa0706245 - DOI - PubMed

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