Change in Proteinuria and Renal Function in Patients with Type 2 Diabetes Receiving Standard Treatment

抄録

In patients with type 2 diabetes, proteinuria is generally considered to be a major factor in the progression to end-stage kidney disease (ESKD) and cardiovascular events. The exacerbation of proteinuria is mainly associated with high blood glucose, hypertension and dyslipidemia. This study is a single-center retrospective cohort study using a large number of patients with type 2 diabetes to investigate the correlation among proteinuria, blood glucose, blood pressure and renal function based on the standard treatment. Patients with type 2 diabetes (n=739) were divided into three groups according to their HbA1c levels, such as HbA1c < 7% ; Group L, 7%≤ HbA1c < 8% ; Group M, and 8% ≤ HbA1c; Group H. A multiple logistic regression model was used to identify the risk associated with those parameters in type 2 diabetes. There was a significant relationship between the increase of proteinuria and the unsatisfactory control of blood pressure (systolic blood pressure of more than 130 mmHg) in all patients with type 2 diabetes. Under the satisfactory control of blood glucose (HbA1c < 7% ; Group L), the annual change of proteinuria (ΔuACR/year) and renal function (ΔeGFR/year), in the patients with an sBP of less than 130mmHg with or without renin-angiotensin system inhibitor (RASI) were milder than in those patients with an sBP of more than 130 mmHg. Therefore, simultaneous strict control of HbA1c and blood pressure with or without renin-angiotensin system inhibitor (RASI) administration are essential in for maintaining renal function in patients with type 2 diabetes.