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하종영(Chong Y . Ha),장현철(Hyun C . Jhang),최은영(Eun Y . Choi),박성광(Sung K . Park),백홍선(Hong S . Baek),강성귀(Sung K . Kang) 대한내과학회 1992 대한내과학회지 Vol.43 No.4
N/A Background: About one-half of type 1 diabetics, develop renal failure in a mean of 20years. Before the advent of dialysis and transplantion, renal failure was the leading cause of death in patients with diabetes. Even now, renal failure remains a major cause of death in diabetic patients. Extensive efforts are therefore being made to prevent kidney damage in diabetic patients. A major goal of physician working in this area has been to understand the natural history of diabetic nephropathy. Methods: Among 722patients with diabetes mellitus (DM) who were admitted to the Chonbuk National University Hospital during the period of 5years from 1986 to 1990, 98patients with diabetic nephropathy that were able to follow up were studied clinically concerning incidence of diabetic nephropathy, and prevalence of hyperlipidemia, hypertension, and clinical course in insulin-dependent diabetes mellitus (IDDM) and noninsuli-dependent diabetes mellitus (NIDDM), respectively. Results: In 247cases of diabetic patient 59.5% was from 50 to 60years old. Among them IDDM was 29.2%, NIDDM was 70.9%, Diabetic nephropathy developed in 55.6% of patient with IDDM, 33.1% of patients with NIDDM, suggesting IDDM may be more frequent than NIDDM in the development of diabetic nephropathy, In distribution by age, 61.2% was in 50 to 60years. During from onset of DM to diabetic nephropathy was 16.5±9years in IDDM, 9.5±5years in NIDDM, Especially 35% of diabetic nephropathy was occurred from 16 to 20years in IDDM, 37.9% from 6 to 10years in NIDDM, respectively. Frequence of hypertension associated with diabetic nephropathy was in 75.0% IDDM and 81.0% in NIDDM, respectively, In laboratory finding values for plasma triglyceride, cholesterol and glucose showed no significant difference between IDDM and NIDDM. Frequence of diabetic retinopathy associated with diabetic nephropathy showed 74.2% in IDDM, and 51.4% in NIDDM, suggesting IDDM may be more frequent than that of NIDDM. Frequency of chronic renal failure after diabetic nephropathy was 26.4% in IDDM and 10.4% in NIDDM, suggesting IDDM may be twice as frequent as NIDDM. Mortality rate showed 38.5% in hemodialysis and 40% in continuous ambulatory peritoneal dialysis. Difference by dialysis method in the mortality rate was not significant. Overall mortiality rate showed 13.3%. Concloaion: These observation strongly indicate that diabetic nephropathy may be more frequent in IDDM and early diagnosis and treatment may be very important in IDDM.