Chronic kidney disease in the type 2 diabetic patients: prevalence and associated variables in a random sample of 2642 patients of a Mediterranean area

BMC Nephrology

Marc Saez⁴  Josep Franch-Nadal⁷  Belen Benito⁸  Pilar Roura¹  Josep MA Pepió²  Antonio Rodriguez-Poncelas³  Manel Mata-Cases⁵  Gabriel Coll-de-Tuero⁶ 

[1] Departement of Medical Sciences, University Autònoma of Barcelona, Barcelona, Spain;Primary Healthcare Center Tortosa Oest, Tortosa, Spain;Primary Healthcare Center Anglès, Research Unit, I.A.S, Salt, Spain;Applied Economics and Health(GRECS), Department of Economics, University of Girona, Girona, Spain;Primary Healthcare Center La Mina, Institut Catalá de la Salut, Barcelona, Spain;Primary Healthcare Center Anglès, Department of Medical Sciences, University of Girona, Girona, Spain;Primary Healthcare Center, Raval Sud, Barcelona, Spain;Primary Healthcare Center, Raval Sud, Institut Catalá de la Salut, Barcelona, Spain

关键词: Diabetic nephropathy;    Albuminuria;    Renal impairment;    Kidney disease;   

Others  :  1083486
DOI  :  10.1186/1471-2369-13-87

 received in 2012-03-27, accepted in 2012-07-27,  发布年份 2012

【 摘 要 】

Background

Kidney disease is associated with an increased total mortality and cardiovascular morbimortality in the general population and in patients with Type 2 diabetes. The aim of this study is to determine the prevalence of kidney disease and different types of renal disease in patients with type 2 diabetes (T2DM).

Methods

Cross-sectional study in a random sample of 2,642 T2DM patients cared for in primary care during 2007. Studied variables: demographic and clinical characteristics, pharmacological treatments and T2DM complications (diabetic foot, retinopathy, coronary heart disease and stroke). Variables of renal function were defined as follows: 1) Microalbuminuria: albumin excretion rate & 30 mg/g or 3.5 mg/mmol, 2) Macroalbuminuria: albumin excretion rate & 300 mg/g or 35 mg/mmol, 3) Kidney disease (KD): glomerular filtration rate according to Modification of Diet in Renal Disease < 60 ml/min/1.73 m² and/or the presence of albuminuria, 4) Renal impairment (RI): glomerular filtration rate < 60 ml/min/1.73 m², 5) Nonalbuminuric RI: glomerular filtration rate < 60 ml/min/1.73 m² without albuminuria and, 5) Diabetic nephropathy (DN): macroalbuminuria or microalbuminuria plus diabetic retinopathy.

Results

The prevalence of different types of renal disease in patients was: 34.1% KD, 22.9% RI, 19.5% albuminuria and 16.4% diabetic nephropathy (DN). The prevalence of albuminuria without RI (13.5%) and nonalbuminuric RI (14.7%) was similar. After adjusting per age, BMI, cholesterol, blood pressure and macrovascular disease, RI was significantly associated with the female gender (OR 2.20; CI 95% 1.86–2.59), microvascular disease (OR 2.14; CI 95% 1.8–2.54) and insulin treatment (OR 1.82; CI 95% 1.39–2.38), and inversely associated with HbA1c (OR 0.85 for every 1% increase; CI 95% 0.80–0.91). Albuminuria without RI was inversely associated with the female gender (OR 0.27; CI 95% 0.21–0.35), duration of diabetes (OR 0.94 per year; CI 95% 0.91–0.97) and directly associated with HbA1c (OR 1.19 for every 1% increase; CI 95% 1.09–1.3).

Conclusions

One-third of the sample population in this study has KD. The presence or absence of albuminuria identifies two subgroups with different characteristics related to gender, the duration of diabetes and metabolic status of the patient. It is important to determine both albuminuria and GFR estimation to diagnose KD.

【 授权许可】

   
2012 Coll-de-Tuero et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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