Renal function decrement in type 2 diabetes mellitus patients in Cipto Mangunkusumo Hospital.
OBJECTIVE
to screen for reduction of renal function in type 2 diabetes mellitus (DM) patients based on various estimated Glomerular Filtration rate (eGFR).


METHODS
1283 newly registered type 2 DM patients were included in the study room from the year 2003 until 2006. We calculated the eGFR by the Cockroft-Gault (CG), Cockroft-Gault adjusted for body surface area (CG-BSA), 4-variables Modification of Diet in Renal Disease (MDRD), and Chinese adapted MDRD (C-MDRD) methods based on serum creatinine. We also investigated the significant risk factors based on the method with the highest percentage of renal dysfunction.


RESULTS
type 2 DM patients with serum creatinine > or = 2 mg/dL (the abnormal limit in Indonesia) was only 5.8%, but the prevalence of patients with eGFR<60mL/mnt was 36.1% (CG), 43.7% (CG-BSA), 13.2% (MDRD), or 22.8% (C-MDRD). We used CG-BSA to determine risk factors as the highest method with highest percentage of renal dysfunction. Significant risk factors for renal dysfunction based on multivariate analysis were history of hypertension (P=0.025, 95%Cl 1.08-3.19), proteinuria (P=0.015, 95%Cl 1.13-3.22), and diabetic retinopathy (P=0.001, 95% Cl 1.43-4.20).


CONCLUSIONS
the use of eGFR is recommended to screen in type 2 DM patients than the use of mere serum creatinine. We advocate the use of CG-BSA method to increase the physician's awareness, as more subjects will fall within the ambit of CKD.
Triyanti
Kuspuji
K
Department of Internal Medicine, Faculty of Medicine, University of Indonesia-dr, Cipto Mangunkusumo Hospital, Jakarta Pusat. triyanti.k@gmail.com
Suhardjono
Soewondo
Pradana
P
Shatri
Hamzah
H
D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
D003404:Creatinine