THE EVALUATION OF NEPHROPATHY RISK FACTORS IN TYPE 2 DIABETES

Abstract

Introduction: The prevalence of diabetes has been increasing at an alarming rate worldwide. Thus, the complications of diabetes are increasingly prevalent and each year three million people die as a result of its chronic complications. In our study, we aimed to compare nephropathic and non neplzropathic patients according to socio-denzographic features, biochemical parameters, and proteinuria characteristics. Methods: Data of 923 type 2 diabetic patients, who were admitted to our Department between January 2000 and December 2008, were analysed retrospectively. The records of 378 patients were included in the study and classified as normoalbuminuric, microalbuminuric and macroalbumhzuric. These groups were compared in terms of demographic, clinical and laboratory findings to investigate the risk factors related to nephropathy. Results: Of the 378 patients, 224 were female (59%) and 154 were male (41%). The mean age was 58.9 +/- 9.7 years. A total of 100 patients (265%) with micro and macroalbuminuria were identified as nephropathic. In the nephropathic group, the levels of FBG (Fasting Blood Glucose), PBG (Postprandial Blood Glucose), HbAl c (Hemoglobin Al c= glycosylated hemoglobin), urea, and creatinine, and the duration of known diabetes were significantly increased when compared with the non-nephropathic group. Diastolic blood pressure and urea levels were significantly higher and creatinine clearance was significantly lower in the macroalbuminuric group. Conclusion: We found a significant relationship between nephropathy and HbAl c, an important indicator of blood glucose control. Therefore, it is essential to provide aggressive blood pressure management and long-term glycaeinic control in order to reduce cardiovascular risk, prevent the development of diabetic nephropathy and ESRF (End Stage Renal Failure), and reduce overall mortality and morbidity. Education of diabetic patients about the risks and complications of elevated blood pressure and poor glycaemic control is a critical component of clinical practice.