title: Prevalence and risk factors of albuminuria and chronic kidney disease in Chinese population with type 2 diabetes and impaired glucose regulation: Shanghai diabetic complications study (SHDCS).
abstract: BACKGROUND
  Diabetes is a major risk factor for the development of kidney disease. We aimed to determine the prevalence of albuminuria and chronic kidney disease (CKD) in Chinese subjects with diabetes and pre-diabetes and the risk factors for kidney disease.
  
  
  METHODS
  An urban community-based sample of 3714 adults in Shanghai was classified into normal glucose tolerance (NGT), impaired glucose regulation (IGR) and diabetes. The estimated glomerular filtration rate (eGFR) and the urinary albumin-to-creatinine ratio (ACR) were applied to designate renal function and albuminuria, respectively. Binary logistic regression was performed to analyse the contribution of risk factors to CKD. Polynominal regression was used to determine the trends of eGFR with the increment of ACR.
  
  
  RESULTS
  The prevalence of microalbuminuria, macroalbuminuria and CKD in subjects with diabetes was 22.8%, 3.4% and 29.6%, respectively, which was significantly higher than that in non-diabetes subjects. After adjustment for age, the odds ratio of hypertension for albuminuria and renal insufficiency (eGFR <60 mL/min/1.73 m(2,) stages 3-5 of CKD) were 1.23 (P = 0.000) and 2.55 (P = 0.000). Diabetes and cardiovascular disease (CVD) both increased the risk for albuminuria significantly, with the odds ratio of 1.22 (P = 0.04) and 1.36 (P = 0.006), respectively. Diabetes and CVD were not independent risk factor for renal insufficiency. Although the worsening trends of eGFR are similar in diabetes and IGR subjects, IGR was not a significant risk factor for albuminuria and renal insufficiency.
  
  
  CONCLUSIONS
  Screening for albuminuria and eGFR is highly recommended for older patients with diabetes, hypertension and CVD to prevent end-stage kidney disease.
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Clinical Center of Diabetes, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China. wpjia@sjtu.edu.cn
authors.forename: Weiping
authors.initials: W
authors.lastname: Jia
authors.forename: Xin
authors.initials: X
authors.lastname: Gao
authors.forename: Can
authors.initials: C
authors.lastname: Pang
authors.forename: Xuhong
authors.initials: X
authors.lastname: Hou
authors.forename: Yuqian
authors.initials: Y
authors.lastname: Bao
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Wenxia
authors.initials: W
authors.lastname: Wang
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Zuo
authors.forename: Huilin
authors.initials: H
authors.lastname: Gu
authors.forename: Kunsan
authors.initials: K
authors.lastname: Xiang
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000453:epidemiology* / Q000209:etiology*; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism*; D003928:Diabetic Nephropathies / Q000453:epidemiology*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014504:Urban Health
chemical_list: D005947:Glucose