Risk factors for albuminuria, renal impairment in Type 2 diabetes revealed

7 September 2010

MedWire News: Swedish researchers have found that older age, high systolic blood pressure (BP), and high triglycerides increase the risk for albuminuria and renal impairment in patients with Type 2 diabetes.

Maria Svensson (University of Gothenburg) and team recruited 3667 patients, aged 30–74 years, with Type 2 diabetes from the Swedish National Diabetes Register. The participants were followed-up for incidence of renal impairment or albuminuria for 5 years.

The Modification of Diet in Renal Disease (MDRD) and Cockgroft–Gault (C–G) formulas were used to measure renal function, and factors associated with albuminuria and renal impairment were also assessed.

Over the study period, 20% and 11% of the cohort developed albuminuria and renal impairment, respectively. Of those who developed albuminuria, 16% and 10% developed renal impairment according to the MDRD and C–G formulas, respectively.

Following multivariate analysis, the team found that each additional year of age, mmHg of systolic BP, or mmol/l of triglycerides, significantly increased the risk for renal impairment or albuminuria.

Body mass index (BMI) was also a significant predictor of both renal impairment and albuminuria, but the type of association depended on the type of equation used. Each one standard deviation (SD) increase in BMI (5 kg/m²) was linked to significantly increased risk for both outcomes using the MDRD equation, whereas one SD decrease in BMI was associated with significantly increased risk for renal dysfunction using the C–G equation.

Poor glycemic control, male gender, low high-density lipoprotein cholesterol, and smoking were significant predictors of albuminuria, but not renal impairment, whereas female gender and high baseline creatinine significantly predicted renal impairment alone (using MDRD and C–G equations).

“We show that the modifiable risk factors elevated systolic BP and elevated serum triglycerides are independent predictors for development of renal dysfunction in Type 2 diabetes, but also that overweight and obesity are strongly related to development of renal disease,” write the authors.

“Furthermore, our study emphasizes the need for more studies on methods to determine renal function in population-based studies, since the currently used formulae (MDRD and C–G) generate different results, especially with regard to body composition and gender,” they conclude.

The results of this study are published in the journal Nephrology, Dialysis and Transplantation.

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Nephrol Dial Transplant 2010; Advance online publication