Effects of glucose and blood pressure control on diabetic kidney disease in old patients with type 2 diabetes

Diabetology & Metabolic Syndrome

Harn-Shen Chen³  Yu-Hsin Chen²  Tzu-En Wu¹ 

[1] Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan;Division of Nephrology, Department of Medicine, Taipei City Hospital Yangming Branch, Taipei, Taiwan;Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan

关键词: Diabetic kidney disease;    Blood pressure;    Old patients;    Type 2 diabetes;   

Others  :  1115104
DOI  :  10.1186/1758-5996-6-81

 received in 2014-03-25, accepted in 2014-07-16,  发布年份 2014

【 摘 要 】

Aims

We determined the influence of age on the effects of glucose and blood pressure control on diabetic kidney disease in patients with type 2 diabetes.

Methods

A total of 721 patients with type 2 diabetes, aged 41–85 years and with an estimated glomerular filtration rate (eGFR) ≥30 mL/ [min · 1.73 m²], were enrolled in this study between August 2001 and December 2002. All participants were followed up at our clinics until December 31, 2010. Primary outcomes were the development of end-stage renal disease (ESRD) and all-cause mortality. Secondary outcomes were the development of clinical albuminuria and a severe decline in eGFR.

Results

During the follow-up period (median: 8.3 years), 27 (3.7%) patients developed ESRD, 130 (18.0%) patients died without developing ESRD, and 16 (2.2%) patients died after developing ESRD. Mortality rate increased with age, but the incidence rate of ESRD did not. Poor glucose and blood pressure control was associated with the development of clinical albuminuria and with a severe decline in eGFR in younger patients with diabetes, but not in older patients. The development of severe decline in eGFR and ESRD was significantly lower in the middle tertile of blood pressure (i.e., SBP of 128–141 mm Hg) in older patients.

Conclusions

Adequate glucose and blood pressure control did not reduce the risk of ESRD; however, it may have delayed the onset of clinical albuminuria as well as eGFR decline in younger patients with type 2 diabetes.

【 授权许可】

   
2014 Wu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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