Nephropathy in type 2 diabetics : predictive factors and evolving aspects.

INTRODUCTION

Diabetic nephropathy (DN) is the most common cause of end-stage renal disease.

AIM

To study the evolution of nephropathy in a group of type 2 diabetics in order to determine the predictive factors of progression.

METHODS

We conducted a longitudinal retrospective, descriptive study witch involved 100 type 2 diabetics patients with confirmed DN for at least 10 years. The patients were divided into 2 groups according to the evolution of their DN: stable DN (group 1) and progressive DN (group 2).

RESULTS

At the time of diagnosis of DN, the majority (82%) of the patients were in the stage of incipient DN while 18% were in the stage of established DN. Univariate regression analysis showed that higher baseline values of albuminuria (p=0.038), creatinine (p=0.001), systolic blood pressure (p=0.009), uricemia (p=0.01) as well as a lower glomerular filtration rate (GFR) (p<0.001), and smoking (p=0.023) were significantly associated with an unfavorable evolution of DN.A high mean value during monitoring in albuminuria (p<0.001), creatinine (p<0.001), systolic blood pressure (p<0.001), uric acid (p<0.001) as well as a lower GFR (p<0.001), and a higher frequency of hypertriglyceridemia (p=0.004) were considered to be risk factors for an unfavorable development of DN detectable during follow-up.

CONCLUSION

We have found several predictors of the progression of DN in our work whose multifactorial approach could improve the outcome of our patients as well as their quality of life.