Prevalence of Overt Nephropathy and Its Associated Factors in Type 2 Diabetes Mellitus at Maharat Nakhon Ratchasima Hospital
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Abstract
Objective: To determine the prevalence of overt nephropathy and the factors associated with this condition among diabetic patients at the Diabetic Clinic, Department of Medicine, Maharat Nakhon Ratchasima Hospital. Patients & Methods: A cross-sectional hospital-based study of diabetic registry in 2003. Overt nephropathy was defined as positive urine dipstick test at least 1+ in two collections excluding patients with non-diabetic kidney disease. Results: The study include 962 patients with type 2 diabetes, consisted of 699 females and 263 males. The prevalence of overt nephropathy founded in this study was 25.6%, and 59.9% of the patients had developed chronic kidney disease (CKD) stage 3 or higher. The factors associated with the presentation of overt proteinuria were the duration of diabetes >20 years, systolic blood pressure of >160 mmHg, serum triglyceride of >150 mg/dL and the presence of diabetic retinopathy. Conclusions: Overt nephropathy was a very common complication of type 2 diabetes. Early urine screening test for urine microalbumin and estimated GFR should be done for early diagnosis and early treatment of diabetic nephropathy which could prevent the progression to end-stage renal disease.
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References
A dler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR; UKPDS GROUP. Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int 2003; 63: 225-32.
Krairythichai U, Supaporn T, Lekayanonth S, Teepasan T, Tangsiripat R, Chittinand A, et al. Thailand Registry of Renal Replacement Therapy. J Nephrol Soc Thai 2003; 9: 210-25.
Ritz E, Orth SR. Nephropathy in patients with type 2 diabetes mellitus. N Engl J Med 1999; 341: 1127-33.
Garg JP, Bakris GL. Microalbuminuria: marker of vascular dysfunction, risk factor for cardio vascular disease. Vasc Med 2002; 7: 35–43.
Nelson RG, Knowler WC, Pettitt DJ, Saad MF, Bennett PH. Diabetic kidney disease in Pima Indians. Diabetes Care 1993; 16: 335-41.
Expert committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003; 26 (Suppl 1): S5-20.
National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002; 39 (Suppl 2): S1-266.
Levey AS, Greene T, Beck GL, Caggiula AW, Kusek JW, Hunsicker LG, et al. Dietary protein restriction and the progression of chronic renal disease: what have all of the results of the MDRD study shown? Modification of Diet in Renal Disease Study group. J Am Soc Nephrol 1999; 10: 2426-39.
Ngarmukos C, Bunnag P, Kosachunhanun N, Krittiyawong S, Leelawatana R, Prathipanawatr T, et al. Thailand diabetes registry project: prevalence, characteristics and treatment of patients with diabetic nephropathy. J Med Assoc Thai 2006; 89 (Suppl 1): S37-42.
American Diabetes Association. Standards of medical care in Diabetes 2007. Diabetes care 2007; 30 (Suppl 1): S4-S41.
Middleton RJ, Foley RN, Hegarty J, Cheung CM, McElduff P, Gibson JM, et al. The unrecognized prevalence of chronic kidney disease in diabetes. Nephrol Dial Transplant 2006; 21: 88-92.
Kong AP, So WY, Szeto CC, Chan NN, Luk A, Ma RC,et al. Assessment of glomerular filtration rate in addition to albuminuria is important in managing type II diabetes. Kidney Int 2006; 69: 383-7.
Gall MA, Hougaard P, Borch-Johnson K, Parving HH. Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study. BMJ 1997; 314: 783-8.
Retnakaran R, Cull CA, Thorne KI, Adler AI, Holman RR; UKPDS Study Group. Risk factors for renal dysfunction in type 2 diabetes: U.K. Prospective Diabetes Study 74. Diabetes 2006; 55: 1832-9.
Gall MA, Nielsen FS, Smidt UM, Parving HH. The course of kidney function in type 2 (non-insulin-dependent) diabetic patients with diabetic nephropathy. Diabetologia 1993; 36: 1071-8.
Adler AI, Stratton IM, Neil HA, Yudkin JS, Matthews DR, Cull CA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ 2000; 321: 412-9.
Ravid M, Neumann L, Lishner M. Plasma lipids and the progression of nephropathy in diabetes mellitus type II: effect of ACE inhibitors. Kidney Int 1995; 47: 907-10.