Nonalbuminuric renal impairment in type 2 diabetic patients and in the general population (national evaluation of the frequency of renal impairment cO-existing with NIDDM [NEFRON] 11).
Nonalbuminuric renal impairment in type 2 diabetic patients and in the general population (national evaluation of the frequency of renal impairment cO-existing with NIDDM [NEFRON] 11).
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DOI：
10.2337/dc08-2186
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发表时间：
2009-08
期刊：
影响因子：
16.2
通讯作者：
Atkins RC
中科院分区：
文献类型：
--
作者：
Thomas MC;Macisaac RJ;Jerums G;Weekes A;Moran J;Shaw JE;Atkins RC
大多数肾功能受损的糖尿病患者的尿白蛋白排泄率在正常范围内。在这些患者中，肾损害的病因尚不清楚，也不清楚这种非蛋白尿性肾损害是否是糖尿病所特有的。在这项研究中，我们检查了非蛋白尿性肾损害的发生率和预测因素，（估计肾小球滤过率[eGFR] <60 ml/min/1.73 m2），并将我们的研究结果与澳大利亚糖尿病、肥胖和生活方式研究（AusDiab）调查的普通人群中观察到的比率进行比较（n = 11 247）。23.1%的2型糖尿病患者eGFR <60 ml/min/1.73 m2（95% CI 21.8-24.5%），超过一半（55%）的尿白蛋白排泄率持续在正常范围内。肾功能损害的发生率高于一般人群（校正比值比1.3，95%CI 1.1-1.5，P < 0.01），但仅是由于与蛋白尿相关的慢性肾脏疾病。与此相反，无蛋白尿的糖尿病患者肾损害发生率低于普通人群，与性别、种族和糖尿病病程无关（0.6，0.5-0.7，P < 0.001）。非蛋白尿性肾损害在糖尿病患者中并不常见。然而，其影响可能更为重大。需要新的研究来阐明非蛋白尿性肾病的发病机制、预防和治疗。
Most diabetic patients with impaired renal function have a urinary albumin excretion rate in the normal range. In these patients, the etiology of renal impairment is unclear, and it is also unclear whether this nonalbumunuric renal impairment is unique to diabetes. In this study, we examined the frequency and predictors of nonalbumunuric renal impairment (estimated glomerular filtration rate [eGFR] <60 ml/min per 1.73 m2) in a nationally representative cohort of 3,893 patients with type 2 diabetes and compared our findings with rates observed in the general population from the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) survey (n = 11,247). Of the 23.1% of individuals with type 2 diabetes who had eGFR <60 ml/min per 1.73 m2 (95% CI 21.8–24.5%), more than half (55%) had a urinary albumin excretion rate that was persistently in the normal range. This rate of renal impairment was predictably higher than that observed in the general population (adjusted odds ratio 1.3, 95% CI 1.1–1.5, P < 0.01) but was solely due to chronic kidney disease associated with albuminuria. In contrast, renal impairment in the absence of albuminuria was less common in those with diabetes than in the general population, independent of sex, ethnicity, and duration of diabetes (0.6, 0.5–0.7, P < 0.001). Nonalbuminuric renal impairment is not more common in those with diabetes. However, its impact may be more significant. New studies are required to address the pathogenesis, prevention, and treatment of nonalbuminuric renal disease.
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影响因子：
4.8
作者：
McCullough, Peter A.;Li, Suying;Bakris, George L.
通讯作者：
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