title: Glycaemic changes in patients with chronic kidney disease.
abstract: In Argentina, there have been no studies aimed at establishing the prevalence of dysglycaemia (impaired fasting glucose [IFG], impaired glucose tolerance [IGT] and diabetes mellitus [DM]) in patients with chronic kidney disease (CKD). Our group decided to conduct an observational study to evaluate the frequency with oral glucose tolerance test (OGTT) in CKD patients with no previous data for dysglycaemia in their medical records. OGTT was performed in 254 patients (60.62% male) with stage 3, 4 and 5 CKD under conservative treatment, haemodialysis or transplantation. Results for DM were found in 10 patients according to fasting glucose alone (3.94%; 95% CI: 1.35-6.53%), 11 patients with exclusively the second hour criterion (4.33%; 95% CI: 1.63-7.03%), 15 with both criteria (5.91%; 95% CI: 2.81-9.00%) and 36 patients with at least one criteria (14.17%; 95% CI: 9.69-18.66%). In a multivariate analysis, DM was associated with waist circumference (OR=1.033 per cm; 95% CI, 1.005 to 1.062; P=.019) and with conservative treatment vs. replacement therapy (OR=0.41; 95% CI: 0.19-0.92; P=.028). IGT was evident in 24.6% and 20.3 on conservative vs. replacement therapy, with no statistically significant difference. IFG (ADA criteria) was 19.75 vs. 9.24% in conservative vs. replacement therapy, with a statistically significant difference. OGTT is suggested for all CKD patients since it is able to detect the full range of unknown dysglycaemias, which avoids underdiagnoses and favours performing treatments to prevent progression in DM risk groups (IFG and/or IGT). It also aids in the selection of the most appropriate medication for transplantation or treatment initiation in new cases of undiagnosed DM to decrease morbidity and mortality.
authors.affiliation: Centro de Enfermedades Renales e Hipertensión Arterial (CEREHA), Buenos Aires, Argentina.
authors.forename: Guillermo
authors.initials: G
authors.lastname: De'Marziani
authors.affiliation: Unidad de Trasplante Renopáncreas, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina.
authors.forename: Gervasio
authors.initials: G
authors.lastname: Soler Pujol
authors.affiliation: Unidad de Trasplante Renal, CRAI Sur, H.I.G.A. Gral. San Martín, La Plata, Argentina.
authors.forename: Liliana Miriam
authors.initials: LM
authors.lastname: Obregón
authors.affiliation: Fresenius Medical Care Villa Regina y Choele Choel, Río Negro, Argentina.
authors.forename: Elisa Mabel
authors.initials: EM
authors.lastname: Morales
authors.affiliation: Departamento de Farmacología (Segunda Cátedra), Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Claudio Daniel
authors.initials: CD
authors.lastname: Gonzalez
authors.affiliation: Hospital Militar Central, Buenos Aires, Argentina.
authors.forename: Luciana
authors.initials: L
authors.lastname: Gonzalez Paganti
authors.affiliation: Laboratorio de Lípidos y Aterosclerosis, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires (INFIBIOC), Buenos Aires, Argentina.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Cacciagiú
authors.affiliation: Laboratorio de Lípidos y Aterosclerosis, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires (INFIBIOC), Buenos Aires, Argentina.
authors.forename: Graciela
authors.initials: G
authors.lastname: Lopez
authors.affiliation: Laboratorio de Lípidos y Aterosclerosis, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires (INFIBIOC), Buenos Aires, Argentina.
authors.forename: Laura
authors.initials: L
authors.lastname: Schreier
authors.affiliation: Centro de Enfermedades Renales e Hipertensión Arterial (CEREHA), Buenos Aires, Argentina. Electronic address: alicia.elbert.nd@gmail.com.
authors.forename: Alicia
authors.initials: A
authors.lastname: Elbert
mesh_terms: D000328:Adult; D000368:Aged; D001118:Argentina; D001786:Blood Glucose; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000378:metabolism*
chemical_list: D001786:Blood Glucose
keywords: Chronic kidney disease; Diabetes; Enfermedad renal crónica; Glucemia alterada en ayunas; Haemodialysis; Hemodiálisis; Impaired fasting glucose; Impaired glucose tolerance; Oral glucose tolerance test; Prueba de tolerancia oral a la glucosa; Tolerancia alterada a la glucosa; Transplantation; Trasplante