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Course of glomerular filtration rate in albuminuric type 2 diabetic patients with or without diabetic glomerulopathy.
Diabetes Care. 2000 Apr; 23 Suppl 2:B14-20.DC

Abstract

OBJECTIVE

To evaluate and compare the clinical course and prognosis in type 2 diabetic patients with persistent albuminuria, with biopsy-proven diabetic glomerulosclerosis (DG), or with nondiabetic glomerulopathies (NDG).

RESEARCH DESIGN AND METHODS

A kidney biopsy was performed in 34 consecutive type 2 diabetic patients with persistent albuminuria (> or = 300 mg/24 h). Glomerular filtration rate (GFR) (51Cr-EDTA) was determined at least once a year, and albuminuria, arterial blood pressure, and HbA1c were determined every 3-6 months.

RESULTS

The biopsy revealed DG in 26 patients (25 men/1 woman) (DG group), age 52 +/- 2 (mean +/- SEM) years, and NDG in 8 patients (7 men/1 woman) (NDG group), age 54 +/- 3 years. The patients were followed for a median of 7.7 years (range 1.0-14.2). In the DG group, GFR decreased from 82 (24-146) to 38 (2-116) ml.min-1.1.73 m-2 (P < 0.001), with a median rate of decline in GFR of 5.6 (0.3-21.6) ml.min-1.year-1, and in the NDG group, GFR decreased from 107 (89-135) to 90 (17-119) ml.min-1.1.73 m-2 (P < 0.05), with a median rate of decline in GFR of 1.3 (0.3-7.6) ml.min-1.year-1 (P < 0.05 between groups). In the DG group, albuminuria increased from 1.4 (0.3-7.2) to 2.6 (0.1-21.6) g/24 h (P < 0.05) and in the NDG group, decreased from 2.2 (0.8-8.7) to 0.8 (0.2-2.5) g/24 h (P = 0.05). Mean arterial blood pressure (MABP) decreased from 118 +/- 3 to 104 +/- 3 mmHg (P < 0.05) in the DG group, whereas it remained unchanged in the NDG group (106 +/- 3 vs. 105 +/- 3 mmHg). In the DG group, the rate of decline in GFR correlated with systolic blood pressure (r = 0.62, P < 0.001), MABP (r = 0.52, P < 0.01), albuminuria (r = 0.55, P < 0.005), and GFR at entry (r = -0.45, P < 0.05).

CONCLUSIONS

Our study demonstrated a more rapid decline in GFR and a progressive rise in albuminuria in type 2 diabetic patients with DG compared with type 2 diabetic patients with NDG.

Authors+Show Affiliations

Steno Diabetes Center, Gentofte, Denmark.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10860186

Citation

Christensen, P K., et al. "Course of Glomerular Filtration Rate in Albuminuric Type 2 Diabetic Patients With or Without Diabetic Glomerulopathy." Diabetes Care, vol. 23 Suppl 2, 2000, pp. B14-20.
Christensen PK, Gall MA, Parving HH. Course of glomerular filtration rate in albuminuric type 2 diabetic patients with or without diabetic glomerulopathy. Diabetes Care. 2000;23 Suppl 2:B14-20.
Christensen, P. K., Gall, M. A., & Parving, H. H. (2000). Course of glomerular filtration rate in albuminuric type 2 diabetic patients with or without diabetic glomerulopathy. Diabetes Care, 23 Suppl 2, B14-20.
Christensen PK, Gall MA, Parving HH. Course of Glomerular Filtration Rate in Albuminuric Type 2 Diabetic Patients With or Without Diabetic Glomerulopathy. Diabetes Care. 2000;23 Suppl 2:B14-20. PubMed PMID: 10860186.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Course of glomerular filtration rate in albuminuric type 2 diabetic patients with or without diabetic glomerulopathy. AU - Christensen,P K, AU - Gall,M A, AU - Parving,H H, PY - 2000/6/22/pubmed PY - 2000/10/7/medline PY - 2000/6/22/entrez SP - B14 EP - 20 JF - Diabetes care JO - Diabetes Care VL - 23 Suppl 2 N2 - OBJECTIVE: To evaluate and compare the clinical course and prognosis in type 2 diabetic patients with persistent albuminuria, with biopsy-proven diabetic glomerulosclerosis (DG), or with nondiabetic glomerulopathies (NDG). RESEARCH DESIGN AND METHODS: A kidney biopsy was performed in 34 consecutive type 2 diabetic patients with persistent albuminuria (> or = 300 mg/24 h). Glomerular filtration rate (GFR) (51Cr-EDTA) was determined at least once a year, and albuminuria, arterial blood pressure, and HbA1c were determined every 3-6 months. RESULTS: The biopsy revealed DG in 26 patients (25 men/1 woman) (DG group), age 52 +/- 2 (mean +/- SEM) years, and NDG in 8 patients (7 men/1 woman) (NDG group), age 54 +/- 3 years. The patients were followed for a median of 7.7 years (range 1.0-14.2). In the DG group, GFR decreased from 82 (24-146) to 38 (2-116) ml.min-1.1.73 m-2 (P < 0.001), with a median rate of decline in GFR of 5.6 (0.3-21.6) ml.min-1.year-1, and in the NDG group, GFR decreased from 107 (89-135) to 90 (17-119) ml.min-1.1.73 m-2 (P < 0.05), with a median rate of decline in GFR of 1.3 (0.3-7.6) ml.min-1.year-1 (P < 0.05 between groups). In the DG group, albuminuria increased from 1.4 (0.3-7.2) to 2.6 (0.1-21.6) g/24 h (P < 0.05) and in the NDG group, decreased from 2.2 (0.8-8.7) to 0.8 (0.2-2.5) g/24 h (P = 0.05). Mean arterial blood pressure (MABP) decreased from 118 +/- 3 to 104 +/- 3 mmHg (P < 0.05) in the DG group, whereas it remained unchanged in the NDG group (106 +/- 3 vs. 105 +/- 3 mmHg). In the DG group, the rate of decline in GFR correlated with systolic blood pressure (r = 0.62, P < 0.001), MABP (r = 0.52, P < 0.01), albuminuria (r = 0.55, P < 0.005), and GFR at entry (r = -0.45, P < 0.05). CONCLUSIONS: Our study demonstrated a more rapid decline in GFR and a progressive rise in albuminuria in type 2 diabetic patients with DG compared with type 2 diabetic patients with NDG. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/10860186/Course_of_glomerular_filtration_rate_in_albuminuric_type_2_diabetic_patients_with_or_without_diabetic_glomerulopathy_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=10860186.ui DB - PRIME DP - Unbound Medicine ER -