Diabetes, Vol 43, Issue 4 572-579, Copyright © 1994 by American Diabetes Association

ARTICLES

Incidence of renal failure in NIDDM. The Oklahoma Indian Diabetes Study

ET Lee, VS Lee, M Lu, JS Lee, D Russell and J Yeh
Center for Epidemiologic Research, University of Oklahoma Health Sciences Center, Oklahoma City 73190.

The incidence of and risk factors for renal failure were determined in 912 Oklahoma Indians with non-insulin-dependent diabetes mellitus in a follow-up study conducted between 1987 and 1990. The incidence rate was 15.7/1,000 person-years after an average follow-up time of 10.2 years. Among those who had no qualitatively positive proteinuria at baseline, the incidence of renal failure was 10.3/1,000 person-years compared with 19.3- and 56.2/1,000 person-years, respectively, in those with slight and heavy proteinuria at baseline. Fasting plasma glucose (FPG) > or = 11.1 mM (200 mg/dl) increased the risk of renal failure to 2.9-fold (95% confidence interval [CI] = 1.9-4.6) higher than a level < 7.8 mM (140 mg/dl), and twofold (95% CI = 1.4-3.1) higher than a level between 7.8 (140 mg/dl) and 11.1 mM (200 mg/dl). The hypertensive patient had twice the incidence of renal failure than the normotensive subject (rate ratio = 2.1, 95% CI = 1.4-3.0). Patients with a lower blood pressure under antihypertensive medication had a lower incidence of renal failure than those whose hypertension remained uncontrolled with or without use of medication. Significant independent risk factors for renal failure, identified from Cox's proportional hazards model, were duration of diabetes, FPG, age, hypertension, and insulin use (P < 0.05). In patients without proteinuria at baseline, FPG and hypertension were significant predictors of renal failure as identified by multivariate analyses, whereas in patients who had proteinuria at baseline, insulin use was significant. Thus, hyperglycemic and hypertension control are suggested strongly for diabetic Oklahoma Indians as potential strategies to prevent the development of renal failure.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				C. E. Lok, M. J. Oliver, D. M. Rothwell, and J. E. Hux The growing volume of diabetes-related dialysis: a population based study Nephrol. Dial. Transplant., December 1, 2004; 19(12): 3098 - 3103. [Abstract] [Full Text] [PDF]

				G. Bruno, A. Biggeri, F. Merletti, G. Bargero, S. Ferrero, G. Pagano, and P. C. Perin Low Incidence of End-Stage Renal Disease and Chronic Renal Failure in Type 2 Diabetes: A 10-year prospective study Diabetes Care, August 1, 2003; 26(8): 2353 - 2358. [Abstract] [Full Text] [PDF]

				P. S. Mehler and R. Estacio Smoking and Abnormalities in Renal Function Ann Intern Med, July 3, 2001; 135(1): 67 - 67. [Full Text] [PDF]

				M. J. Zychma, E. Zukowska-Szczechowska, B. I. Lacka, and W. Grzeszczak Angiotensinogen M235T and chymase gene CMA/B polymorphisms are not associated with nephropathy in type II diabetes Nephrol. Dial. Transplant., December 1, 2000; 15(12): 1965 - 1970. [Abstract] [Full Text] [PDF]