2020 Volume 63 Issue 6 Pages 390-398
Typical diabetic nephropathy develops with the appearance of microalbuminuria, followed by the appearance of overt proteinuria, resulting in a decreased renal function. In clinical practice, however, since there are cases in which the renal function declines without the appearance of overt proteinuria, the present state and contributing factors at this center were examined. The eGFR slope was calculated for 1326 patients with type 2 diabetes mellitus in whom the eGFR had been measured more than 8 times in the 2 years until June 2017, and cases with less than -5 mL/min/1.73 m2/year were classified as Rapid decliners. Overall, 174 cases (13.1 %) were Rapid decliners. Even if limited to 1106 cases with stage 1 or 2 nephropathy, 119 cases (10.8 %) were Rapid decliners. A logistic regression analysis showed that low hemoglobin at baseline was a significant independent risk factor for a Rapid decline in the eGFR in all cases and in stage 1, 2, and 3 nephropathy.
