Mur Martí T, Franch Nadal J, Morató Griera J, Llobera Serentill A, Vilarrubias Calaf M, Ros Espin C
Area Básica de Salud Raval Sud, Barcelona.
Aten Primaria. 1995 Nov 30;16(9):516-24.
To study the population receiving care to find the prevalence of diabetic Nephropathy (DNP) and its association with possible risk factors in type 2 Diabetes Mellitus.
A descriptive crossover study.
An urban health district with an aged and socio-economically depressed population.
Randomised sampling among the health district's registered diabetics (n = 198).
Among other parameters, the values of Proteinuria and Microalbuminuria in 24 hour's urine and of serum Creatinine were analysed. On the basis of these values the four stages of DNP were established: I) Normality, II) Microalbuminuria, III) Proteinuria, IV) Renal failure. The prevalences recorded were 33.8%, 51%, 11.1% and 4%, respectively. Also studied was the value of Microalbuminuria measured at random by reactive strips dipped in urine, which displayed 78% sensitivity and 68% specificity. The most notable of the DNP risk factors were how long the DM had evolved (p = 0.005). Age (p = 0.02), the value of the glucosilated haemoglobin (p = 0.03) and of the triglycerides (p = 0.03) were also related factors. On analysing the association of DNP with other chronic complications of DM, a statistical relationship to the presence of Retinopathy (p < 0.001) and peripheric Vasculopathy (p < 0.001) was observed.
The presence of some stage of DNP among the type 2 DM population is very common. Only 33.8% of the sample was normal regarding the urinary excretion of proteins. Microalbuminuria quantified at random with reactive strips has low specificity. The highest risk factor for DNP is the length of the DM's evolution, with age and metabolic control of the disease also being important.
研究接受护理的人群，以确定糖尿病肾病（DNP）的患病率及其与2型糖尿病可能的危险因素之间的关联。
一项描述性交叉研究。
一个人口老龄化且社会经济状况低迷的城市健康区。
在该健康区登记的糖尿病患者中进行随机抽样（n = 198）。
除其他参数外，分析了24小时尿液中的蛋白尿和微量白蛋白尿值以及血清肌酐值。根据这些值确定了DNP的四个阶段：I）正常，II）微量白蛋白尿，III）蛋白尿，IV）肾衰竭。记录的患病率分别为33.8%、51%、11.1%和4%。还研究了用浸入尿液的反应试纸随机测量的微量白蛋白尿值，其灵敏度为78%，特异性为68%。DNP最显著的危险因素是糖尿病的病程（p = 0.005）。年龄（p = 0.02）、糖化血红蛋白值（p = 0.03）和甘油三酯值（p = 0.03）也是相关因素。在分析DNP与糖尿病其他慢性并发症的关联时，观察到与视网膜病变（p < 0.001）和外周血管病变（p < 0.001）的存在有统计学关系。
2型糖尿病患者中存在某种阶段的DNP非常常见。只有33.8%的样本在蛋白质尿排泄方面正常。用反应试纸随机定量的微量白蛋白尿特异性较低。DNP的最高危险因素是糖尿病的病程，年龄和疾病的代谢控制也很重要。
