Monitoring of patients with type 2 diabetes and nephropathy in a specialized diabetic nephropathy clinic seems to be beneficial. Issue 5 (September 2018)

• Record Type: Journal Article
• Authors: Vallianou, N.; Stratigou, T.; Paikopoulou, A.; Apostolou, T.; Vlassopoulou, B.; Tsagarakis, S.; Ioannidis, G.
• Is Part Of: Diabetes & metabolic syndrome. Volume 12:Issue 5(2018)
• Page Start: 689
• Page End: 692
• Publication Date: 2018-09
• Subjects: ACE-I angiotensin-converting-enzyme inhibitors -- ALP alkaline phosphatase -- ARBs angiotensin 2 receptor blockers -- BMI body mass index -- CKD-EPI chronic kidney disease epidemiology collaboration -- CVD cardiovascular disease -- ESRD end stage renal disease -- GFR glomerular filtration rate -- GGT gamma-glutamyl-transferase -- HDL-Cholesterol high-density-lipoprotein cholesterol -- INT Intensive diabetes therapy -- LDL-Cholesterol low-density-lipoprotein cholesterol -- SGOT aspartate transferase -- SGPT alanine-transferase -- RRT renal replacement therapy -- UAE urinary albumin excretion; Diabetic nephropathy -- eGFR -- HbA1c -- UAE levels; Diabetes -- Periodicals; Metabolism -- Disorders -- Periodicals; Diabetes Mellitus -- Periodicals; Metabolic Diseases -- Periodicals; Diabète -- Périodiques; Métabolisme, Troubles du -- Périodiques; Endocrinologie -- Périodiques; Diabète -- Physiopathologie -- Périodiques; Diabetes; Metabolism -- Disorders; Electronic journals; Periodicals; 616.462
• DOI: 10.1016/j.dsx.2018.04.012
• Languages: English
• ISSNs: 1871-4021

Abstract

Abstract: Background: The purpose of this study was to evaluate the outcome of DM2 patients with nephropathy when they are under surveillance of a joined clinic run by endocrinologists & nephrologists. Patients and methods: A cohort of 106 patients with DM2, 42–83 years of age, and eGFR < 60 ml/min/m 2 were included. Age, sex, duration of diabetes, duration of attending our clinic, smoking habits, BMI, data regarding ischemic heart disease and induction of hemodialysis, urine albumin excretion (UAE) levels, eGFR (MDRD equation) and values of various biochemical parameters were recorded too. Follow-up period ranged from one to 25 years. Paired samples t -test and non-parametrical Kruskal–Wallis test were used for the analyses of the data. Results: Fifty percent of patients had no further progression, 25.9% improvement, while 24.1% had worsening of the UAE levels. During the follow-up in the joined clinic, there was a smaller than the expected from the medical literature decrease in median eGFR, i.e. 2, 3 ml/min/m 2 and a statistically significant improvement in glycosylated hemoglobin levels from 8.0% to 7.4% (p = 0.016). Time in years of follow-up in the joined clinic of our hospital appeared to be the most significant factor in the improvement or stabilization against deterioration of the UAE levels (p = 0.018). Conclusions: Close follow-up of DM2 patients with eGFR < 60 ml/min/m 2 has resulted in a minor annual eGFR decrease. Monitoring of these patients in a specialized diabetic nephropathy clinic is beneficial for this group of patients for delaying the occurrence of end-stage renal disease.