Early-onset Type 2 Diabetes:High Risk Factor For End-stage Renal Disease In Patients With Diabetic Kidney Disease

Aims:We aim to explore the relationship between early-onset type 2diabetes mellitus(T2DM)and end-stage renal disease(ESRD)in patients with diabetic kidney disease(DKD).Materials and Methods:1111 T2DM patients with DKD were enrolled in this study.We used the age at diabetes diagnosis of younger than 40 to define early-onset and 40 years and above to define late-onset.Medical history,anthropometry and laboratory indicators were documented.ESRD was defined by estimated glomerular filtration rate(eGFR)<15mL/min/1.73 m~2 or dialysis.Logistic regression analysis was used to explore the association between early-onset diabetes and ESRD.Results:Early-onset diabetes patients were more likely to be male,young,and had a history of smoking and drinking.They had a longer diabetes duration,higher body mass index(BMI),worse blood lipid metabolism profile and less likely to receive oral hypoglycemic drugs,antihypertensive drugs and renin-angiotensin-system(RAS)blockers.Compared with late-onset subjects,the prevalence of ESRD was 2-fold higher in early-onset T2DM patients[(9.2%v.s.4.3%),P=0.009].Univariate analysis showed that early-onset diabetes,diabetes duration,history of hypertension,systolic blood pressure(SBP),insulin therapy and antihypertensive drugs were risk factors for ESRD in patients with DKD(P<0.05).In multivariate logistic analysis,patients with early-onset T2DM exhibited 3.58-fold higher risk of ESRD than subjects with late-onset[95%CI 1.47 to 8.74;P=0.005]after adjusting for sex,traditional metabolic factors,drug factors and diabetes duration.Conclusions:In patients with DKD,early-onset type 2 diabetes is an independent risk factor of ESRD.