Nephropathy in type 2 diabetics : predictive factors and evolving aspects

Abstract

Abstract :
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 diabeticsin order to determine the predictive factors of progression.
Methods : We conducted a longitudinal retrospective, descriptive study 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 incipientDN 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 unfavorableevolution of DN.A high mean value during monitoring in albuminuria (p<0.001), creatinine (p<0.001), systolicblood pressure (p<0.001), uric acid (p<0.001) as well as a lower GFR (p<0.001) and a higherfrequency of hypertriglyceridemia (p=0.004) were considered to be risk factors for anunfavorable development of DN detectable during follow-up.
Conclusion :We have found several predictors of progression of DN in our work whose multifactorial approachcould improve the outcome of our patients as well as their quality of life.