A Cross-Sectional Survey In Luzhou Region On Chronic Kidney Disease To The Patients For Aged40Years Old And Above With Hyperglycemia

Objective: To investigate the prevalence and risk factors ofchronic kidney disease to patients with type2diabetes mellitus（T2DM）andpre-diabetes for aged40years old and above in Luzhou region. StudyPopulation and Methods: Based on the baseline of epidemiology of tyep2diabetes mellitus,3872normal glucose tolerance (NGT),1464T2DM and2210people with impaired glucose regulation(IGR) were investigated who were over40years old from April to November in2011. The contents of the studyincluded questionnaires (demographic characteristics、 history of chronicdisease、previous history、family history and behavioral risk factors)、physicalexaminations (height、weight、waist circumference、hip circumference andblood pressure)、blood (fasting blood glucose、2-hours postprandial glucose、hemoglobinA1c、blood lipid and blood creatinine) and urine tests (albuminuriaand urinary creatinine).The microalbuminuria(MAU) refered to the urinaryalbumin-to-creatinine ratio (ACR) reaches up to2.5-25mg/mmol (male) or3.5-35mg/mmol (female). The eGFR was calculated according to theModification of Diet in Renal Disease (MDRD), while the definition andstages of chronic kidney disease (CKD) refered to2002Kidney DiseaseOutcomes Quality Initiative of the National Kidney Foundation(NKF-K/DOQI).SPSS21.0software was used to analyse all the data in order to estimate theprevalence of CKD. Then, logistic regression analysis method was applied to analyse risk factors of MAU and renal insufficiency to hyperglycemiapopulation. Results:1.In Luzhou region, the prevalence rate of MAU and CKDwere23.4%and25.5%in the subjects with T2DM aged40years old andabove(21.5%、22.8%in newly diagnosed DM and25.2%、28.17%in knownsubjects with DM). The prevalence rate of MAU and CKD were13.5%and15.2%in the patients with IGR.2. In Luzhou region, The prevalence rate ofCKD1、2、and3-4were14.6%、6.6%and4.4%respectively in the patients withT2DM, and8.5%、4.1%、2.6%respectively in the patients with IGR.3. Theprevalence rate of MAU and CKD in hyperglycaemia were increasing withincreases of age、hemoglobinA1c and duration of diabetes(P＜0.01）. What’smore, the prevalence of MAU、CKD and renal insufficiency were significantlyhigher in the T2DM and IGR with hypertension and history ofcardiovascular-disease(P＜0.05).4.Among1464DM, normoalbuminuria was76.4%, of which2.5%in patients with eGFR<60ml/min/1.73m2. Theprevalence of renal insufficiency in patients with DM was4.4%, of which43.8%in patients with normalalbuminuria. Among2210IGR group,normalalbuminuria was86.5%, of which2.4%in patients witheGFR<60ml/min/1.73m2. The prevalence of renal insufficiency in patients withIGR was3.0%, of which69.7%in patients with normalalbuminuria. Throughscatter plot observation on eGFR and ACR value with different glucosemetabolism status, showed that is with the decrease of eGFR, ACR value had atrend of increase.5.Multifactor analysis showed that age、hemoglobinA1c、serum creatinine(Scr)、hypertension and history of cardiovascular disease were all risk factors of MAU, while hypertension、age、dyslipidemia and Scr wererisk factors of renal insufficiency. Age、hypertension and Scr were thecommon risk factors for proteinuria and renal insufficiency. Conclusion:1.InLuzhou region, the prevalence of MAU and CKD was high in T2DM aged over40, and so do the newly diagnosed T2DM and pre-diabetes.2.Screening foralbuminuria and eGFR is highly recommended for patients with hyperglycemia,hypertension, dyslipidemia and cardiovascular disease to find early renalimpairment, especially for old people.3.This shows the significance to lowerblood pressure, blood glucose and blood lipid in the prevention and treatmentof diabetic nephropathy.