Early intensive treatment improves outcomes in patients with glomerular hyperfiltration and type 2 diabetes

Medicina clínica
Maria-Isabel TroyaRamón Romero

Abstract

Approximately 24-40% of patients with type 2 diabetes mellitus (T2DM) develop kidney damage. Our objective was to evaluate the long-term evolution of renal function using isotopic determination of GFR and urinary albumin excretion (UAE) in patients with T2DM undergoing intensive treatment for renal and cardiovascular risk factors. This was a single-center, prospective study of 201 patients with T2DM and UAE who initiated intensive treatment. They were followed for 17.2±6.5 years. Patients were divided into three groups, according to renal function: 167(85.6%) had stable renal function, 16(8.2%) had creatinine levels that doubled and 12(6.2%) began renal replacement therapy (RRT). We performed periodic isotopic determinations of GFR using (125)I-iothalamate. There were significant differences between the three groups with respect to age, duration of T2DM at baseline, years of follow-up in the study and systolic blood pressure, serum creatinine, isotopic GFR, and UAE at baseline. Renal function evolution slopes were -1.55mL/min/1.73m(2)/year in patients with stable creatinine, -2.49mL/min/1.73m(2)/year in those with doubled creatinine, and -8.16mL/min/1.73m(2)/year in those requiring RRT. We also found that differences in renal e...Continue Reading

References

Dec 5, 1990·JAMA : the Journal of the American Medical Association·R E SchmiederB Nunez
Apr 12, 2002·The New England Journal of Medicine·Giuseppe RemuzziPiero Ruggenenti
Mar 13, 2003·Kidney International·William F KeaneUNKNOWN RENAAL Study Investigators
May 17, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Néstor FontseréRamón Romero
Oct 13, 2006·Journal of the American Society of Nephrology : JASN·Mauro AbbateGiuseppe Remuzzi
Feb 8, 2008·The New England Journal of Medicine·Peter GaedeOluf Pedersen
Nov 8, 2011·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Nagi AltemtamMeguid El Nahas
Nov 15, 2011·The New England Journal of Medicine·UNKNOWN DCCT/EDIC Research GroupBernard Zinman
Dec 6, 2011·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Rieko OkadaSeiichi Matsuo
Jan 28, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Giacomo ZoppiniEnzo Bonora
Jul 10, 2012·Diabetes Care·Piero RuggenentiUNKNOWN GFR Study Investigators

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

CV Disorders & Type 2 Diabetes

This feed focuses on the association of cardiovascular diseases in patients with type 2 diabetes.

Biomarkers for Type 2 Diabetes

Biomarkers can help understand chronic diseases and assist in risk prediction for prevention and early detection of diseases. Here is the latest research on biomarkers in type 2 diabetes, a disease in which the body is unable to produce or properly use insulin.

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.