title: A possible relationship between renal impairment and complications development in type 2 diabetes mellitus: a prospective, observational study in Italy.
abstract: BACKGROUND
  We investigated the relationship between complications development and estimated glomerular filtration rate (eGFR), in a cohort of type 2 diabetes mellitus (T2DM) outpatients.
  
  
  METHODS
  This observational study considered 1284 T2DM outpatients, who had been followed-up for 4.5 ± 1.6 years. eGFR was estimated using Chronic Kidney Disease Epidemiology Collaboration equation. The independent relationship between development of complications and clinical data was evaluated, and hazard ratio (HR) by Cox regression analysis calculated.
  
  
  RESULTS
  Mean age of the population was 66.8 ± 10.4 years; mean serum creatinine and eGFR were 1.05 ± 0.36 mg/dl and 71.6 ± 21.6 ml/min/1.73 m(2), respectively. Complications including death (14.2% of the whole population) were recorded in 504 subjects (39.3%). Patients with complications were older and more frequently male with history of hypertension, coronary heart disease, congestive heart disease, retinopathy, nephropathy and had higher levels of glycated hemoglobin. At Cox regression analysis, eGFR was the major risk factor for development of complications, and the HR increased according with lower eGFR (HR 1.53 and 1.86, for eGFR<45 and<30 ml/min/1.73 m(2), respectively).
  
  
  CONCLUSIONS
  In our cohort of T2DM outpatients, a reduced eGFR was associated with an increased risk of complications development.
authors.affiliation: Clinica Medica, Department of Medical Sciences, University Hospital St. Anna, Ferrara. Electronic address: f.fabbian@ospfe.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Fabbian
authors.affiliation: Clinica Medica, Department of Medical Sciences, University Hospital St. Anna, Ferrara.
authors.forename: Alfredo
authors.initials: A
authors.lastname: De Giorgi
authors.affiliation: Diabetes and Clinical Nutrition, University Hospital St. Anna, Ferrara.
authors.forename: Marcello
authors.initials: M
authors.lastname: Monesi
authors.affiliation: Clinica Medica, Department of Medical Sciences, University Hospital St. Anna, Ferrara.
authors.forename: Marco
authors.initials: M
authors.lastname: Pala
authors.affiliation: Clinica Medica, Department of Medical Sciences, University Hospital St. Anna, Ferrara.
authors.forename: Ruana
authors.initials: R
authors.lastname: Tiseo
authors.affiliation: Nephrology and Dialysis, University Hospital St. Anna, Ferrara.
authors.forename: Silvia
authors.initials: S
authors.lastname: Forcellini
authors.affiliation: Nephrology and Dialysis, University Hospital St. Anna, Ferrara.
authors.forename: Alda
authors.initials: A
authors.lastname: Storari
authors.affiliation: Diabetes and Clinical Nutrition, University Hospital St. Anna, Ferrara.
authors.forename: Roberto
authors.initials: R
authors.lastname: Graziani
authors.affiliation: Department of Internal Medicine and Biomedical Science, University of Parma, Parma.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Volpi
authors.affiliation: Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), University College London Medical School, University College London (UCL), London, UK.
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
authors.affiliation: Clinica Medica, Department of Medical Sciences, University Hospital St. Anna, Ferrara.
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredini
mesh_terms: D000368:Aged; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology
keywords: Complications; Glomerular filtration rate; Kidney; Outpatients; Type 2 diabetes mellitus