title: Kidney dysfunction and related cardiovascular risk factors among patients with type 2 diabetes.
abstract: BACKGROUND
  Kidney dysfunction is a strong predictor of end-stage renal disease and cardiovascular (CV) events. The main goal was to study the clinical correlates of diabetic kidney disease in a large cohort of patients with type 2 diabetes mellitus (T2DM) attending 236 Diabetes Clinics in Italy.
  
  
  METHODS
  Clinical data of 120 903 patients were extracted from electronic medical records by means of an ad hoc-developed software. Estimated glomerular filtration rate (GFR) and increased urinary albumin excretion were considered. Factors associated with the presence of albuminuria only, GFR < 60 mL/min/1.73 m(2) only or both conditions were evaluated through multivariate analysis.
  
  
  RESULTS
  Mean age of the patients was 66.6 ± 11.0 years, 58.1% were male and mean duration of diabetes was 11.1 ± 9.4 years. The frequency of albuminuria, low GFR and both albuminuria and low GFR was 36.0, 23.5 and 12.2%, respectively. Glycaemic control was related to albuminuria more than to low GFR, while systolic and pulse pressure showed a trend towards higher values in patients with normal kidney function compared with those with both albuminuria and low GFR. Multivariate logistic analysis showed that age and duration of disease influenced both features of kidney dysfunction. Male gender was associated with an increased risk of albuminuria. Higher systolic blood pressure levels were associated with albuminuria, with a 4% increased risk of simultaneously having albuminuria and low GFR for each 5 mmHg increase.
  
  
  CONCLUSIONS
  In this large cohort of patients with T2DM, reduced GFR and increased albuminuria showed, at least in part, different clinical correlates. A worse CV risk profile is associated with albuminuria more than with isolated low GFR.
authors.affiliation: Unit of Internal Medicine, Scientific Institute, San Giovanni Rotondo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: De Cosmo
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Rossi
authors.forename: Fabio
authors.initials: F
authors.lastname: Pellegrini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lucisano
authors.forename: Simonetta
authors.initials: S
authors.lastname: Bacci
authors.forename: Sandro
authors.initials: S
authors.lastname: Gentile
authors.forename: Antonio
authors.initials: A
authors.lastname: Ceriello
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Russo
authors.forename: Antonio
authors.initials: A
authors.lastname: Nicolucci
authors.forename: Carlo
authors.initials: C
authors.lastname: Giorda
authors.forename: Francesca
authors.initials: F
authors.lastname: Viazzi
authors.forename: Roberto
authors.initials: R
authors.lastname: Pontremoli
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000453:epidemiology / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
keywords: albuminuria; epidemiology; type 2 diabetes