Goicochea-Rios Evelyn Del Socorro, Yupari-Azabache Irma Luz, Otiniano Nélida Milly, Gómez Goicochea Néstor Iván
School of Medicine, Universidad César Vallejo, Trujillo, Peru.
Institutos Y Centros de Investigación, Universidad César Vallejo, Trujillo, Peru.
Int J Nephrol Renovasc Dis. 2024 Nov 27;17:289-300. doi: 10.2147/IJNRD.S489891. eCollection 2024.
Chronic kidney disease affects the quality of life of people with diabetes mellitus, increases cardiovascular risk, and has high social costs.
To determine associated factors for chronic kidney disease in people with diabetes mellitus type 2.
Retrospective cohort study with 371 patients evaluated in primary care for diabetes mellitus. Information on age, sex, disease duration, comorbidity and laboratory results was obtained. Patients of both sexes attended between 2022 and 2024 were included. Patients with other renal diseases or referrals were excluded. Logistic regression analysis was performed to identify associated factors.
Males (p = 0.014), age >60 years, (p = 0.01) uncontrolled diabetes (HbA1C >7.99%±1.84) and disease duration over 20 years (p = 0.02) are associated factors for chronic kidney disease (CKD). HbA1c had significant differences between those with and those without CKD. The most frequent comorbidities are arterial hypertension (70%), dyslipidemia (43%), overweight/obesity (44%) and anemia (31%). CKD stage G2 is the most frequent (45%). One hundred percent of patients in G1 and G2 CKD stages have an elevated microalbuminuria/creatinuria rate, and 13% of patients between G3a and G4 stages have this rate within normal values. Most patients receive nephroprotection with ARA II and ACEIs.
It is important to screen for kidney disease in patients with diabetes mellitus type 2 who are male, over 60 years of age, with uncontrolled HbA1c and prolonged disease duration, as well as to treat comorbidities and nephroprotection regardless of the stage of chronic kidney disease.
慢性肾脏病会影响糖尿病患者的生活质量，增加心血管疾病风险，且社会成本高昂。
确定2型糖尿病患者慢性肾脏病的相关因素。
对371例在初级保健机构接受糖尿病评估的患者进行回顾性队列研究。获取了年龄、性别、病程、合并症和实验室检查结果等信息。纳入2022年至2024年间就诊的男女患者。排除患有其他肾脏疾病或已转诊的患者。进行逻辑回归分析以确定相关因素。
男性（p = 0.014）、年龄>60岁（p = 0.01）、糖尿病控制不佳（糖化血红蛋白>7.99%±1.84）以及病程超过20年（p = 0.02）是慢性肾脏病（CKD）的相关因素。糖化血红蛋白在有CKD和无CKD的患者之间存在显著差异。最常见的合并症是动脉高血压（70%）、血脂异常（43%）、超重/肥胖（44%）和贫血（31%）。CKD G2期最为常见（45%）。G1和G2期CKD患者的微量白蛋白尿/肌酐尿率均升高，G3a至G4期患者中有13%的该比率在正常范围内。大多数患者接受了血管紧张素II受体拮抗剂（ARA II）和血管紧张素转换酶抑制剂（ACEIs）的肾脏保护治疗。
对于男性、年龄超过60岁、糖化血红蛋白控制不佳且病程较长的2型糖尿病患者，筛查肾脏疾病非常重要，无论慢性肾脏病处于何种阶段，都要治疗合并症并进行肾脏保护。
