Hospitalized Patients With Diabetic Nephropathy Related Factors Analysis

With the rapid economic development and the acceleration of the industrialization process, the prevalence of diabetes mellitus and the number of diabetic patients dramaticcly increased in China.The China National Diabetes and Metabolic Disorders Study Group,had done a epeidemilogy study in2007-08.46,239adults aged20years and over selected from14provinces and autonomous regions to represent nationwide data.It found that92,400,000diabetic patients and148,200,000pre-diabetic population.[1]If blood glucose and other cardiovascular risk factors are not well controlled, serious complications can develop in patients with diabetes.The chronic complications include cardioovascular diseases, peripheral vascular diseases, kidney, retinopathy and neuropathy, affecting the quality of life of hundreds of millions of people Among the chronic complications of diabetes, macro-vascular complications are the most dangerous and leading causes of death.Diabetic nephropathy (diabetic nephropathy, DN) is one of the serious complications..In patients with diabetes, the incidence of cronic kidney disease is30%-40%in life time. Currently, the diagnosis of DN is mainly through determination of urinary albumin excretion rate (UAER).In recent years studies showed a considerable proportion of patients with abnormal kidney function in patients with diabetes without abuminuria.It suggested that the decline of renal function in diabetes is more complicated than we thought.[10]Studies show that cardiovascular events increased significantly in type2diabetic patients with decreased renal function irrespective to the accompanying urinary protein level and the level of metabolic control.[48]Impaired renal function without proteinuria in type2diabetes is a particular type.Objective to investigate the microalbuminuria negative in type2diabetic patients with renal dysfunction and its related factors. Methods From Janurary2010to April2011,797patients with type2diabetes mellitus patients hospitalized in the department of Endocrinology were included. Albumin negative was defined as24h of urinary albumin excretion (MALB)<30mg the glomerular filtration rate (eGFR) lower than60ml/min was defined as impaired renal function group (eGFR was calculated with MDRD formula.Results①Renal insufficiency occurred at2.6in the hospitalized patients with type2diabetes mellitus.②Age, course, blood pressure in patients with microalbuminuria was significantly higher than that without microalbuminuria (P<0.05).③Age in patients with renal insufficiency with microalbuminuria was significantly older than that with normal renal function group (P<0.05).④In the urine micro albumin negative Age group, BMI, WC in patients with renal function decline without microalbuminuria were significantly higher than those with normal renal function group (P<0.05).⑤Among patients with renal insufficiency, BMI, WC, the prevalence of fatty liver in those with microalbuminuria were significantly higher than those without microalbuminuria (P<0.05).⑥The diabetes course and blood pressure in patients positive independent risk factors for microalbuminuriaand renal dysfunction. Conclusion Obesity was associated with decreased renal function in patients withtype2diabetes without microalbuminuria.