Increased Renal Arterial Resistance Predicts the Course of Renal Function in Type 2 Diabetes With Microalbuminuria
Article Figures & Tables
Figures
- FIG. 1.
Kaplan-Meier analysis, corrected for lipid, A1C, blood pressure levels, and smoking habits, of time to the predefined primary end point, e.g., an yearly decline of GFR ≥−3 ml/min per 1.73 m2 in the 59 patients with an R/I index ≥80 and in the 98 patients with an R/I index <80 during the 7.8-year follow-up period. The percentage of patients with a yearly decrease of GFR ≥−3 ml/min per 1.73 m2 was two to three times greater in patients with an R/I ≥80.
Tables
- TABLE 1
Demographic and clinical characteristics of the hypertensive, microalbuminuric type 2 diabetic patients at baseline
Characteristics R/I P value ≥80 <80 n 59 98 Age (years) 62 ± 8 64 ± 9 NS Duration of diabetes (years) 13 ± 4 12 ± 5 NS Systolic/diastolic blood pressure (mmHg) 132/80 ± 11/5 133/79 ± 13/7 NS Plasma cholesterol (mg/dl) 221 ± 15 189 ± 16 P < 0.05 Plasma triglycerides (mg/dl) 187 ± 32 147 ± 31 P < 0.05 A1C (%) 7.3 ± 0.6 7.4 ± 0.7 NS Sex (male/female) 40/19 60/38 NS Coronary artery disease (%) 41 12 P < 0.01 Carotid artery disease (%) 31 9 P < 0.01 Peripheral artery disease (%) 40 19 P < 0.01 Renal histological category 1 (n) 36/59 30/98 P < 0.01 Renal histological category 2 (n) 19/59 21/98 P < 0.01 Renal histological category 3 (n) 4/59 47/98 P < 0.01 Smoking habit (%) 39 12 P < 0.01 Data are means ± SD. Blood pressure and glucose control values were those during the entire period of follow-up with drug treatments.
- TABLE 2
GFR and AER at baseline and after 8 years in patients with R/I ≥80 or <80 and patients showing regression to normoalbuminuria and progression to proteinuria
Group 1 (R/I <80) Group 2 (R/I ≥80 Baseline 8 years Baseline 8 years GFR (ml · min–1 · 1.73 m–2) 98 ± 2 91 ± 7 97 ± 11 70 ± 8*† AER (μg/mg) 81 (32–240) 40 (11–339)* 88 (31–261) 81 (13–570) Normoalbuminuria (%) — 31 — 7† Proteinuria (%) — 5 — 24† Data are means ± SE, median (range), and %.
- *
* P < 0.05 baseline vs. 8 years.
- †
† P < 0.01 group 1 vs. group 2.
- TABLE 3
Relative risk (RR) of a decrease of GFR per year >3.0 ml · min–1 · 0.1.73 m–2 according to selected variables (multivariate analysis) with relative P values
Variable Relative risk P value R/I ≥80 at baseline 10.7 (3.3–15.1) P < 0.0001 Baseline GFR 1.8 (0.8–2.9) NS Baseline AER 1.9 (0.7–3.2) NS Combined artery disease 5.2 (1.3–7.1) P < 0.05 Renal histological category at base line 6.1 (2.0–12.4) P < 0.01 Duration of the disease 1.1 (0.6–1.8) NS A1C during follow-up 1.2 (0.4–2.2) NS Blood pressure during follow-up 1.3 (0.6–2.7) NS Smoking habit (%) 4.3 (1.1–5.9) P < 0.05 Data are means (95% CI).
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