Risk factors for the development and progression of diabetic nephropathy

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Date
2002
Authors
Hussin, Ahmad Munawwir
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Publisher
Universiti Sains Malaysia
Abstract
Risk factors for the development and progression of diabetic nephropathy A study had been carried out in Hospital University Sains Malaysia from 1997 to 2000 to investigate on development and progression of diabetic nephropathy. 1. To identify risk factors for the development of diabetic nephropathy 2. To identify risk factors for the progression of diabetic nephropathy This is a retrospective study. Case records belonging to patients with type 2 diabetes with and without nephropathy were reviewed. They were then grouped into either normoalbuminuria and macroalbuminuria based on their 24 hour urine protein and urine dipstick test for protein. Other related data was also extracted. Of the 200 case notes reviewed, only 86 were included in the final analyses. Twenty five of whom had normoalbuminuria and 61 had macroalbuminuria. On univariate analysis, it was noted that hypertension was the only variable showing significant difference between the two groups (P = 0.03). On mutivariate analysis using logistic regression it was noted that the duration of diabetes mellitus, the levels of serum triglycerides and smoking significantly contributed to the development of diabetic nephropathy. When compared between patients with rapid and slow progression of renal disease, patients with rapid progression had significantly higher mean arterial pressure (P=0.02), systolic blood pressure (P=0.03), diastolic blood pressure (P= 0.04) and has greater protein excretion. In addition the patient with rapid progression had significant strong family history of diabetes mellitus (P = 0.05). Risk factors for the development of diabetic nephropathy were duration of diabetes, serum triglycerides, and smoking habit while risk factors for the progression of diabetic nephropathy were hypertension, 24 hour urine protein and family history of diabetes.
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Keywords
Type 2 diabetes mellitus, nephropathy, risk factors
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