Cardiovascular risk factors and disease management in type 2 diabetic patients with diabetic nephropathy.
OBJECTIVE
The purpose of this study was to assess the prevalence of cardiorenal risk factors, their management in a routine clinical setting, and the actual achievement of international guideline targets in a large cohort of type 2 diabetic patients with diabetic nephropathy.


METHODS
A multicentric cross-sectional study was performed in the Campania region in Italy to evaluate cardiorenal risk factors and their management in light of international guidelines. Overall, 28,550 diabetic patients were screened in the 21 participating centers; 847 (348 male and 449 female) patients with type 2 diabetes and a clinical diagnosis of diabetic nephropathy were recruited.


RESULTS
Of these subjects, 749 had microalbuminuria and 98 had macroalbuminuria. Targets for blood pressure, HbA(1c), LDL cholesterol, HDL cholesterol, and triglycerides were reached in, respectively, 17.5, 32.3, 30.7, 47, and 55.2% of the patients. Chronic renal failure (glomerular filtration rate <60 ml/min) was revealed in 41% and anemia in 23.8% of the patients.


CONCLUSIONS
This is the first study to investigate a large cohort of type 2 diabetic patients with early and moderate diabetic nephropathy strictu sensu. Notably, impaired renal function can be often diagnosed in these patients even in the presence of microalbuminuria. Thus, clinical diagnosis of diabetic nephopathy allows us to identify a group of patients at very high cardiorenal risk, for whom care is really difficult. We suggest that a correct diagnosis of diabetic nephropathy should always be made and that sodium intake and anemia should be routinely evaluated in these patients.
Sasso
Ferdinando C
FC
Department of Clinical and Experimental Medicine Magrassi-Lanzara, Unit of Internal Medicine, Second University of Naples, Via F. Petrarca 64, I-80122 Naples, Italy. ferdinando.sasso@unina2.it
De Nicola
Luca
L
Carbonara
Ornella
O
Nasti
Rodolfo
R
Minutolo
Roberto
R
Salvatore
Teresa
T
Conte
Giuseppe
G
Torella
Roberto
R
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000534:rehabilitation / Q000628:therapy; D003928:Diabetic Nephropathies / Q000150:complications* / Q000628:therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000628:therapy; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors