Risk of development of chronic kidney disease in patients with type 2 diabetes having metabolic syndrome.
OBJECTIVE
To measure the relation of creatinine clearance in type-2 diabetic patients with different components of metabolic syndrome and to quantify the relationship of frequency of incident CKD with increasing number of metabolic syndrome components while controlling for age, gender and duration of diabetes.


METHODS
Cross-sectional descriptive study.


METHODS
Diabetes Clinic, Fauji Foundation Hospital, Rawalpindi, from January to August 2006.


METHODS
Patients having type-2 Diabetes for more than 5 years were enrolled. Information regarding age, gender, duration of diabetes , type of diabetes, treatment taking, complete fasting lipid profile, fasting blood glucose, Body Mass Index (BMI), 24 hours urinary proteins and creatinine clearance, co-existent risk factors like hypertension and ischemic heart disease was taken. Patients were divided into groups having one to all five metabolic syndrome traits. Progressive increase in the metabolic syndrome traits was compared with decline in creatinine clearance. Pearson correlation test and multiple logistic regression were applied to determine correlation with significance at 'r' and 'p' < 0.05.


RESULTS
Out of 104 evaluated female and male patients, 70% had hypertension, ischemic heart disease and a family history of diabetes. While 20% had normal creatinine clearance, 37% had a creatinine clearance between 60-90 ml/min, 19% had a creatinine clearance of 30-59 ml/min, 18% had a creatinine clearance of less than 30 ml/min and 10% were already in stage 5 CKD. The decline in renal function was more severe in subjects evaluated who had a higher number of features of the metabolic syndrome. Age was the only significant determinant of development of CKD (p=0.05).


CONCLUSIONS
The renal function progressively declined with 3 or more features of the metabolic syndrome.
Moin
Shaheen
S
Department of Medicine, Foundation University Medical College, Rawalpinidi, Pakistan.
Gondal
Ghulam Murtaza
GM
Bano
Uzma
U
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006305:Health Status Indicators; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors