Per citar aquest document: http://ddd.uab.cat/record/112838
Chronic kidney disease in the type 2 diabetic patients: prevalence and associated variables in a random sample of 2642 patients of a Mediterranean area
Coll de Tuero, Gabriel (Universitat de Girona)
Mata Cases, Manel (Institut Català de la Salut)
Rodriguez Poncelas, Antonio (I. A. S. (Salt, Girona))
Pepió, Josep M. (Institut Universitari d'Investigació en Atenció Primària (Tortosa, Catalunya))
Roura Olmeda, Pilar (Universitat Autònoma de Barcelona)
Benito, Belén (Institut Català de la Salut)
Franch Nadal, Josep (Institut Català de la Salut)
Sáez i Zafra, Marc (Universitat de Girona)

Data: 2012
Resum: 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.
Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. Creative Commons
Llengua: Anglès
Document: article ; publishedVersion
Matèria: Kidney disease ; Renal impairment ; Albuminuria ; Diabetic nephropathy
Publicat a: BMC Nephrology, Vol. 13, Núm. 87 (August 2012) , p. 1-9, ISSN 1471-2369

DOI: 10.1186/1471-2369-13-87


9 p, 343.2 KB

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