Chronic Kidney Disease and Associated Cardiovascular Risk Factors in Chinese with Type 2 Diabetes

다국어 초록 (Multilingual Abstract)

Background: To determine the frequency of chronic kidney disease (CKD) and its associated risk factors in Chinese type 2 diabetic patients, we conducted a cross-sectional study in Nanjing, China, in the period between January 2008 and December 2009.
Methods: Patients with type 2 diabetes under the care by Jiangsu Province Official Hospital, Nanjing, China were invited for assessment.
CKD was defined as the presence of albuminuria or estimated glomerular filtration rate <60 mL/min/1.73 m2. Albuminuria was defined as urinary albumin-to-creatinine ratio ≥30 mg/g.
Results: We recruited 1,521 urban Chinese patients with type 2 diabetes (mean age, 63.9±12.0 years). The frequency of CKD and albuminuria was 31.0% and 28.9%, respectively. After adjusted by age and sex, hypertension, anemia and duration of diabetes were significantly associated with CKD with odds ratio (95% confidence interval) being 1.93 (1.28 to 2.93), 1.70 (1.09 to 2.64), and 1.03 (1.00 to 1.06), respectively.
Conclusion: In conclusion, CKD was common in the urban Nanjing Chinese with type 2 diabetes. Strategies to prevent or delay progression of kidney disease in diabetes should be carried out at the early disease course of type 2 diabetes.

참고문헌 (Reference)

1 Xu R, "The prevalence and risk factors of kidney disease in type 2 diabetic patients in rural Shanghai" 51 : 18-23, 2012

2 Mohanram A, "The effect of losartan on hemoglobin concentration and renal outcome in diabetic nephropathy of type 2 diabetes" 73 : 630-636, 2008

3 American Diabetes Association, "Standards of medical care in diabetes: 2009" 32 (32): S13-S61, 2009

4 Premaratne E, "Serial measurements of cystatin C are more accurate than creatinine-based methods in detecting declining renal function in type 1 diabetes" 31 : 971-973, 2008

5 American Diabetes Assoication, "Report of the expert committee on the diagnosis and classification of diabetes mellitus" 20 : 1183-1197, 1997

6 Mann JF, "Renal outcomes with telmisartan, ramipril, or both, in people at high vascular risk (the ONTARGET study): a multicentre, randomised, double-blind, controlled trial" 372 : 547-553, 2008

7 Burrows NR, "Racial and ethnic differences in trends of end-stage renal disease: United States, 1995 to 2005" 15 : 147-152, 2008

8 Yang W, "Prevalence of diabetes among men and women in China" 362 : 1090-1101, 2010

9 Jia W, "Prevalence and risk factors of albuminuria and chronic kidney disease in Chinese population with type 2 diabetes and impaired glucose regulation: Shanghai diabetic complications study (SHDCS)" 24 : 3724-3731, 2009

10 Dirren H, "Nutritional status: haematology and albumin. Euronut SENECA investigators" 45 (45): 43-52, 1991

11 Levey AS, "National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification" 139 : 137-147, 2003

12 Perkins BA, "Microalbuminuria and the risk for early progressive renal function decline in type 1 diabetes" 18 : 1353-1361, 2007

13 Babazono T, "Lower haemoglobin level and subsequent decline in kidney function in type 2 diabetic adults without clinical albuminuria" 49 : 1387-1393, 2006

14 KDOQI, "KDOQI clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease" 49 (49): S12-S154, 2007

15 ADVANCE Collaborative Group, "Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes" 358 : 2560-2572, 2008

16 Lu B, "High prevalence of chronic kidney disease in population-based patients diagnosed with type 2 diabetes in downtown Shanghai" 22 : 96-103, 2008

17 Rigalleau V, "Glucose control influences glomerular filtration rate and its prediction in diabetic subjects" 29 : 1491-1495, 2006

18 Duckworth W, "Glucose control and vascular complications in veterans with type 2 diabetes" 360 : 129-139, 2009

19 So WY, "Glomerular filtration rate, cardiorenal end points, and all-cause mortality in type 2 diabetic patients" 29 : 2046-2052, 2006

20 Targher G, "Glomerular filtration rate, albuminuria and risk of cardiovascular and all-cause mortality in type 2 diabetic individuals" 21 : 294-301, 2011

21 Ahmed AT, "Ethnic differences in anemia among patients with diabetes mellitus: the Diabetes Study of Northern California (DISTANCE)" 85 : 57-61, 2010

22 Rigalleau V, "Estimation of glomerular filtration rate in diabetic subjects: Cockcroft formula or modification of Diet in Renal Disease study equation?" 28 : 838-843, 2005

23 Bruno G, "Estimated glomerular filtration rate, albuminuria and mortality in type 2 diabetes: the Casale Monferrato study" 50 : 941-948, 2007

24 Colhoun HM, "Effects of atorvastatin on kidney outcomes and cardiovascular disease in patients with diabetes: an analysis from the Collaborative Atorvastatin Diabetes Study (CARDS)" 54 : 810-819, 2009

25 Rigalleau V, "Cockcroft-Gault formula is biased by body weight in diabetic patients with renal impairment" 55 : 108-112, 2006

26 Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults, "Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary" 68 : 899-917, 1998

27 Poulsen PL, "Clinical evaluation of a test for immediate and quantitative determination of urinary albumin-tocreatinine ratio. A brief report" 21 : 97-98, 1998

28 Iseki K, "Chronic kidney disease in Japan" 47 : 681-689, 2008

29 Hsieh MC, "Chronic kidney disease as a risk factor for coronary artery disease in Chinese with type 2 diabetes" 28 : 317-323, 2008

30 Joint Committee for Developing Chinese guidelines on Prevention and Treatment of Dyslipidemia in Adults, "Chinese guidelines on prevention and treatment of dyslipidemia in adults" 35 : 390-419, 2007

31 Adler AI, "Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study" 321 : 412-419, 2000

32 Stratton IM, "Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study" 321 : 405-412, 2000

33 Kong AP, "Assessment of glomerular filtration rate in addition to albuminuria is important in managing type II diabetes" 69 : 383-387, 2006

34 Mehdi U, "Anemia, diabetes, and chronic kidney disease" 32 : 1320-1326, 2009

35 Sasatomi Y, "Anemia and hypertension are risk factors for both renal prognosis and survival in patients with diabetes mellitus" 13 : 473-479, 2009

36 Hirsch AT, "ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation" 113 : e463-e654, 2006

37 Levey AS, "A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group" 130 : 461-470, 1999

38 Lin CH, "A communitybased study of chronic kidney disease among type 2 diabetics in Kinmen, Taiwan" 75 : 306-312, 2007

39 World Health Organiz, "1999 World Health Organization- International Society of Hypertension Guidelines for the Management of Hypertension: guidelines subcommittee" 17 : 151-183, 1999

40 Holman RR, "10- year follow-up of intensive glucose control in type 2 diabetes" 359 : 1577-1589, 2008