Predictors and generation of risk equations for albuminuria progression in type 2 diabetes

被引:1
作者
Imbroll, Miriam Giordano [1 ,2 ]
Lauretta, Daniele Agius [1 ]
Tabone, Trevor [1 ]
Fava, Stephen [1 ,2 ]
机构
[1] Mater Dei Hosp, Diabet & Endocrine Ctr, MSD-2090 Msida, Malta
[2] Univ Malta, Msida, Malta
关键词
type; 2; diabetes; albuminuria; risk prediction; CIGARETTE-SMOKING; ENDOTHELIAL FUNCTION; HEMOGLOBIN LEVELS; OXIDATIVE STRESS; KIDNEY HYPOXIA; RENAL-DISEASE; INFLAMMATION; NEPHROPATHY; COMPLICATIONS; CONSUMPTION;
D O I
10.5414/CN109010
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Diabetes is the most common cause of end-stage renal disease and is associated with increased mortality. Although only a proportion of type 2 diabetic subjects develop albuminuria or progress, it is not currently possible to identify those patients who will develop this complication or who will progress. Aim: The aim of the study was to identify baseline risk factors for the development and progression of albuminuria in a cohort with type 2 diabetes and use this data to generate risk equations. Patients and methods: Type 2 diabetic subjects who had albumin-creatinine ratio (ACR) measurement in 2007 - 2008 were recruited and followed-up for 8 years. Results: 260 patients were included in the study. Of all the normoalbuminuric and microalbuminuric patients, 24.3% progressed. Baseline HbA1c, white cell count (WCC), smoking, and duration of diabetes were associated with progression of albuminuria stage in univariate analysis. Duration of diabetes (p = 0.034) was independently associated with progression in binary logistic regression. Baseline HbA1c (p = 0.002), age (p = 0.01), serum creatinine (p = 0.02), serum potassium (p = 0.04), serum urea (p = 0.0004), WCC (p = 0.02), serum triglycerides (p = 0.02), systolic blood pressure (p = 0.02), and duration of diabetes (p = 0.003) were positively correlated with percentage change (% change) in ACR, whilst baseline estimated glomerular filtration rate (eGFR) (p = 0.03), serum sodium (p = 0.04), hemoglobin (p = 0.0006), and hematocrit (p = 0.0002) were negatively correlated in Spearman correlation. Duration of diabetes (p = 0.025) and baseline HbA1c (p = 0.02) were independently associated with % change in ACR in multivariate analysis. Based on these results, novel risk equations were generated. Conclusions: We have identified baseline characteristics associated with progression of renal disease in type 2 diabetic subjects and generated equations to estimate the risk of progression. If validated in other populations, these equations might be useful in predicting risk of progression in clinical practice.
引用
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页码:33 / 39
页数:7
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