Asymptomatic bacteriuria in women with diabetes mellitus: effect on renal function after 6 years of follow-up.
BACKGROUND
The long-term consequences of asymptomatic bacteriuria (ASB) on renal function in women with diabetes mellitus (DM) are unknown.


METHODS
A prospective study was performed among women with type 1 or type 2 DM. Women with ASB (diagnosis based on findings from 1 urine culture specimen) were compared with women without ASB for differences in renal function development and incidence of hypertension.


RESULTS
A total of 644 women were included in the study (296 with type 1 DM and 348 with type 2 DM; mean [SD] age, 51 [15] years) and followed up for a mean (SD) duration of 6.1 (1.9) years. The prevalence of ASB was 17%. In women with DM and ASB, the creatinine clearance decreased from 87 mL/min (1.45 mL/s) at baseline to 76 mL/min (1.27 mL/s) at study end point; in women with DM without ASB the creatinine clearance decreased from 97 to 88 mL/min (from 1.62 to 1.47 mL/s). In the multivariate analyses, adjusted for age, length of follow-up, duration of DM, and microalbuminuria at baseline, no association was found between ASB and the relative or the absolute decrease in creatinine clearance; the same results were shown also when women with DM type 1 and women with DM type 2 were analyzed separately. Women with ASB developed hypertension more often than women without ASB (54% vs 37%; P = .045), but there was no significant association in the multivariate analysis (odds ratio, 1.5; 95% confidence interval, 0.7-3.6).


CONCLUSIONS
Women with DM (type 1 or type 2) with ASB do not have an increased risk for a faster decline in renal function or the development of hypertension after 6 years of follow-up.
Meiland
Ruby
R
Department of Internal Medicine and Infectious Diseases, Eijman-Winkler Center for Microbiology and Infectious Diseases, Utrecht, the Netherlands.
Geerlings
Suzanne E
SE
Stolk
Ronald P
RP
Netten
Patrick M
PM
Schneeberger
Peter M
PM
Hoepelman
Andy I M
AI
D000293:Adolescent; D000328:Adult; D000368:Aged; D001437:Bacteriuria / Q000150:complications* / Q000453:epidemiology; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors