Diabetic kidney disease (DKD) is one of the leading causes of end stage renal disease. Despite recent therapies, mortality due to DKD and resources spent on healthcare are important problems. Thus, appropriate markers are needed to predict renal outcomes. Therefore, we investigated the role of peripheral perfusion as an indicator for renal events in patients with type 2 diabetes mellitus. This retrospective cohort study included 566 patients who were admitted to Matsushita Memorial Hospital in Osaka, Japan for type 2 diabetes mellitus. Peripheral perfusion was assessed using perfusion index (PI), which represents the level of circulation through peripheral tissues and was measured on each toe using a Masimo SET Radical-7 (Masimo Corporation, Irvine, CA, USA) instrument. The duration of follow up was 3.0 years. The median age of patients was 70 years (IQR range: 61–77 years) and median PI value was 2.9% (IQR range: 1.8–4.8%). Multiple logistic regression analyses showed that PI (per 1% increase) was associated with an odds ratio of composite of end-stage renal disease (ESRD) and/or doubling of serum creatinine level; n = 40 (odds ratio 0.823 [95% CI: 0.680–0.970]), and composite of ESRD, doubling of serum creatinine level, and renal death and/or cardiovascular death; n = 44 (odds ratio 0.803 [95% CI: 0.665–0.944]). The factors which were statistically significant in univariate analysis and those known to be related factors for renal event were considered simultaneously as independent variables for multiple logistic regression analysis. PI can be a novel indicator for renal events in patients with type 2 diabetes mellitus.

糖尿病肾病（DKD）是终末期肾病的主要原因之一。尽管有最近的治疗方法，但 DKD 导致的死亡率和医疗保健资源消耗仍然是重要的问题。因此，需要适当的标记物来预测肾脏结果。因此，我们研究了外周灌注作为 2 型糖尿病患者肾脏事件指标的作用。这项回顾性队列研究纳入了 566 名因 2 型糖尿病入住日本大阪松下纪念医院的患者。使用灌注指数（PI）评估外周灌注，该指数代表通过外周组织的循环水平，并使用 Masimo SET Radical-7（Masimo Corporation，Irvine，CA，USA）仪器对每个脚趾进行测量。随访时间为3.0年。患者的中位年龄为 70 岁（IQR 范围：61-77 岁），中位 PI 值为 2.9%（IQR 范围：1.8-4.8%）。多重逻辑回归分析表明，PI（每增加 1%）与终末期肾病 (ESRD) 和/或血清肌酐水平加倍的复合比值比相关； n = 40（比值比 0.823 [95% CI：0.680–0.970]），以及 ESRD、血清肌酐水平加倍、肾死亡和/或心血管死亡的复合数据； n = 44（比值比 0.803 [95% CI：0.665–0.944]）。单变量分析中具有统计学意义的因素和已知与肾脏事件相关的因素同时被视为多元逻辑回归分析的自变量。 PI 可以成为 2 型糖尿病患者肾脏事件的新指标。