TORNA ALL’ELENCO

Kidney dysfunction and related cardiovascular risk factors among patients with type 2 diabetes in Nephrology Dialysis Transplantation

2014
ASL Torino 5

Tipo pubblicazione

Article

Autori/Collaboratori (12)Vedi tutti...

De Cosmo S

Rossi MC

Pellegrini F


et alii...

Abstract

BackgroundKidney dysfunction is a strong predictor of end-stage renal disease and cardiovascular (CV) events. The main goal was to study the clinical correlates of diabetic kidney disease in a large cohort of patients with type 2 diabetes mellitus (T2DM) attending 236 Diabetes Clinics in Italy.MethodsClinical data of 120 903 patients were extracted from electronic medical records by means of an ad hoc-developed software. Estimated glomerular filtration rate (GFR) and increased urinary albumin excretion were considered. Factors associated with the presence of albuminuria only, GFR < 60 mL/min/1.73 m 2 only or both conditions were evaluated through multivariate analysis.ResultsMean age of the patients was 66.6 ± 11.0 years, 58.1% were male and mean duration of diabetes was 11.1 ± 9.4 years. The frequency of albuminuria, low GFR and both albuminuria and low GFR was 36.0, 23.5 and 12.2%, respectively. Glycaemic control was related to albuminuria more than to low GFR, while systolic and pulse pressure showed a trend towards higher values in patients with normal kidney function compared with those with both albuminuria and low GFR. Multivariate logistic analysis showed that age and duration of disease influenced both features of kidney dysfunction. Male gender was associated with an increased risk of albuminuria. Higher systolic blood pressure levels were associated with albuminuria, with a 4% increased risk of simultaneously having albuminuria and low GFR for each 5 mmHg increase.ConclusionsIn this large cohort of patients with T2DM, reduced GFR and increased albuminuria showed, at least in part, different clinical correlates. A worse CV risk profile is associated with albuminuria more than with isolated low GFR. © 2014 © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

PMID : 24398892

DOI : 10.1093/ndt/gft506

Keywords

cohort analysis; cardiovascular risk; article; albuminuria; oral antidiabetic agent; aged; age; adult; insulin; hydroxymethylglutaryl coenzyme A reductase inhibitor; fibric acid derivative; dipeptidyl carboxypeptidase inhibitor; albumin; angiotensin receptor antagonist; acetylsalicylic acid; controlled study; diabetic patient; disease association; disease duration; dyslipidemia; female; gender; glomerulopathy; glomerulus filtration rate; glycemic control; high risk patient; human; hypertension; Italy; kidney dysfunction; kidney function; major clinical study; male; medical record review; middle aged; non insulin dependent diabetes mellitus; priority journal; pulse pressure; risk assessment; systolic blood pressure; systolic hypertension; urinary excretion; young adult;