Prolonged elevated postprandial sugar augments severity in kidney disease: a north Indian hospital-based study.
OBJECTIVE
Diabetes plays a major role in progression of renal failure. The risk-factor profile changes during the progression of chronic kidney disease (CKD) from mild/moderate to end-stage renal disease. The relationship between glycemic indices, blood pressure, body mass index (BMI) and age at diagnosis in Indians has been less investigated. We assessed association of these risk factors with CKD stages in Indian population.


METHODS
This study was carried out on patients (n = 162) who were diagnosed with CKD and normal control group (n = 155). For BMI, National Institutes for Health criteria were used to categorize the patients.


RESULTS
The mean age of CKD patients were significantly increased with the advancement of stage. BMI, systolic blood pressure (SBP), postprandial sugar level (PP), urea and creatinine were also significantly higher with elevated stages, whereas no differences were observed in diastolic blood pressure (DBP) and fasting blood sugar (FBS). The logistic regression study gave a significant result (p = 0.000) when we compared the group of CKD patients with established/prolonged postprandial blood sugar. It was independently associated with mild CKD [odds ratio (OR) = 5.213, 95% confidence interval (CI) = 2.06-13.21, p = 0.000], moderate CKD (OR = 7.724, 95% CI = 4.05-14.74, p = 0.000) and severe CKD (OR = 7.610, 95% CI = 4.03-14.36, p = 0.000).


CONCLUSIONS
SBP and PP were the best predictors of prevalent nephropathy in this population, while DBP and FBS were found to be less effective. This may have implication for kidney disease risk stratification and protection.
Department of Nephrology, Institute of Medical Sciences (IMS), Banaras Hindu University, Varanasi , Uttar Pradesh , India .
Subhash
S
Chandra
Alok K
AK
Singh
Mritunjai
M
Singh
Parimal
P
Das
Shivendra
S
Singh
Haushila P
HP
Pandey
Rana G
RG
Singh
D000328:Adult; D000368:Aged; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications*; D016022:Case-Control Studies; D018450:Disease Progression; D006801:Humans; D007194:India; D007676:Kidney Failure, Chronic / Q000209:etiology*; D016015:Logistic Models; D008875:Middle Aged; D019518:Postprandial Period
D001786:Blood Glucose