[Renal insufficiency and its associated factors in type 2 diabetic patients with normoalbuminuria.].
OBJECTIVE
To investigate the prevalence of renal insufficiency and its associated factors in type 2 diabetes mellitus with normoalbuminuria using estimated glomerular filtration rate (eGFR).


METHODS
We retrospectively analyzed 10-year data of chronic complications in type 2 diabetics in-patient from the Chinese Diabetes Society. eGFR was estimated using the equation from Modification of Diet in Renal Disease (MDRD) study. The clinical characteristics as well as associated factors for low eGFR were analyzed among the normoalbuminuric type 2 diabetic patients.


RESULTS
A total of 1351 type 2 diabetic patients were included, 755 patients with normoalbuminuria, 466 patients with microalbuminuria and 130 patients with macroalbuminuria respectively. Among the patients, 310 (22.9%) had low eGFR (GFR < 60 mlxmin(-1) x 1.73 m(-2)), 19.7% (149/755) in the patients with normoalbuminuria, 21.9% (102/466) in microalbuminuria and 45.4% (59/130) in macroalbuminuria. Patients with normoalbuminuria and low eGFR suffered more chronic complications than those with normoalbuminuria and normal eGFR, mainly retinopathy, cerebrovascular diseases and sensory neuropathy. Stepwise logistic regression analysis revealed that age (OR = 1.042, P < 0.001), diabetic duration (OR = 1.038, P = 0.045), systolic blood pressure (OR = 1.017, P < 0.001) were independently associated with renal impairment among the patients with normoalbuminuria. Body mass index (OR = 0.868, P < 0.001) and HbA1c (OR = 0.898, P = 0.021) were also related with renal insufficiency.


CONCLUSIONS
A considerable proportion in type 2 diabetic patients without albuminuria may exist renal impairment, and eGFR estimation could benefit the evaluation of renal function in such patients.
Lu
Wei-Na
WN
Department of Endocrinology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China.
Li
Hong
H
Zheng
Fen-Ping
FP
Huang
Hong
H
Ruan
Yu
Y
D000419:Albuminuria / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005919:Glomerular Filtration Rate; D006801:Humans; D015995:Prevalence; D051437:Renal Insufficiency