Prevalence of diabetic nephropathy in primary care type 2 diabetic patients with hypertension

data from the Korean Epidemiology Study on Hypertension III (KEY III study).

Chul Woo Yang, Jung Tak Park, Yon Su Kim, Yong Lim Kim, Yil Seob Lee, Yoon Sun Oh, Shin-Wook Kang

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

The prevalence of albuminuria is known to be higher in hypertensive compared to normotensive nondiabetic patients. In addition, systolic blood pressure (BP) is found to be an independent risk factor for albuminuria in type 2 diabetes mellitus (T2DM). Based on these findings, the prevalence of albuminuria is expected to be higher in T2DM with hypertension relative to T2DM without hypertension, but it has been largely unexplored. Prevalence rates of microalbuminuria, macroalbuminuria and renal insufficiency (RI) were investigated among 3738 hypertensive T2DM patients from 350 nationwide primary care clinics. Independent factors associated with albuminuria and RI were also characterized. Clinical and laboratory data of 3712 patients were included in the analysis. BP was controlled in only 1164 patients (31.4%). There were 2595 normoalbuminuric patients (70.6%), and microalbuminuria and macroalbuminuria were present in 850 (23.1%) and 230 (6.3%), respectively. The prevalence of RI was 32.1% based on estimated glomerular filtration rate (eGFR) by Modification of Diet in Renal Disease formula. Systolic BP correlated significantly with the natural logarithmic values of urinary albumin-to-creatinine ratio (ACR) (R = 0.16, P < 0.0001). Multivariate logistic regression analysis revealed that male sex, the duration of diabetes, systolic BP, glycated hemoglobin and eGFR were significant independent factors associated with the presence of albuminuria, while advanced age, female sex, the duration of diabetes and urinary ACR were significant independent risk factors for RI. A significant proportion of T2DM patients with hypertension had albuminuria and RI, and the duration of diabetes mellitus rather than the duration of hypertension was a significant independent factor associated with albuminuria and RI.

Original languageEnglish
Pages (from-to)3249-3255
Number of pages7
JournalNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Volume26
Issue number10
DOIs
Publication statusPublished - 2011 Jan 1

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Albuminuria
Diabetic Nephropathies
Primary Health Care
Epidemiology
Renal Insufficiency
Blood Pressure
Hypertension
Type 2 Diabetes Mellitus
Glomerular Filtration Rate
Albumins
Creatinine
Diet Therapy
Glycosylated Hemoglobin A
Diabetes Mellitus
Logistic Models
Regression Analysis
Kidney

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

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title = "Prevalence of diabetic nephropathy in primary care type 2 diabetic patients with hypertension: data from the Korean Epidemiology Study on Hypertension III (KEY III study).",
abstract = "The prevalence of albuminuria is known to be higher in hypertensive compared to normotensive nondiabetic patients. In addition, systolic blood pressure (BP) is found to be an independent risk factor for albuminuria in type 2 diabetes mellitus (T2DM). Based on these findings, the prevalence of albuminuria is expected to be higher in T2DM with hypertension relative to T2DM without hypertension, but it has been largely unexplored. Prevalence rates of microalbuminuria, macroalbuminuria and renal insufficiency (RI) were investigated among 3738 hypertensive T2DM patients from 350 nationwide primary care clinics. Independent factors associated with albuminuria and RI were also characterized. Clinical and laboratory data of 3712 patients were included in the analysis. BP was controlled in only 1164 patients (31.4{\%}). There were 2595 normoalbuminuric patients (70.6{\%}), and microalbuminuria and macroalbuminuria were present in 850 (23.1{\%}) and 230 (6.3{\%}), respectively. The prevalence of RI was 32.1{\%} based on estimated glomerular filtration rate (eGFR) by Modification of Diet in Renal Disease formula. Systolic BP correlated significantly with the natural logarithmic values of urinary albumin-to-creatinine ratio (ACR) (R = 0.16, P < 0.0001). Multivariate logistic regression analysis revealed that male sex, the duration of diabetes, systolic BP, glycated hemoglobin and eGFR were significant independent factors associated with the presence of albuminuria, while advanced age, female sex, the duration of diabetes and urinary ACR were significant independent risk factors for RI. A significant proportion of T2DM patients with hypertension had albuminuria and RI, and the duration of diabetes mellitus rather than the duration of hypertension was a significant independent factor associated with albuminuria and RI.",
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T1 - Prevalence of diabetic nephropathy in primary care type 2 diabetic patients with hypertension

T2 - data from the Korean Epidemiology Study on Hypertension III (KEY III study).

AU - Yang, Chul Woo

AU - Park, Jung Tak

AU - Kim, Yon Su

AU - Kim, Yong Lim

AU - Lee, Yil Seob

AU - Oh, Yoon Sun

AU - Kang, Shin-Wook

PY - 2011/1/1

Y1 - 2011/1/1

N2 - The prevalence of albuminuria is known to be higher in hypertensive compared to normotensive nondiabetic patients. In addition, systolic blood pressure (BP) is found to be an independent risk factor for albuminuria in type 2 diabetes mellitus (T2DM). Based on these findings, the prevalence of albuminuria is expected to be higher in T2DM with hypertension relative to T2DM without hypertension, but it has been largely unexplored. Prevalence rates of microalbuminuria, macroalbuminuria and renal insufficiency (RI) were investigated among 3738 hypertensive T2DM patients from 350 nationwide primary care clinics. Independent factors associated with albuminuria and RI were also characterized. Clinical and laboratory data of 3712 patients were included in the analysis. BP was controlled in only 1164 patients (31.4%). There were 2595 normoalbuminuric patients (70.6%), and microalbuminuria and macroalbuminuria were present in 850 (23.1%) and 230 (6.3%), respectively. The prevalence of RI was 32.1% based on estimated glomerular filtration rate (eGFR) by Modification of Diet in Renal Disease formula. Systolic BP correlated significantly with the natural logarithmic values of urinary albumin-to-creatinine ratio (ACR) (R = 0.16, P < 0.0001). Multivariate logistic regression analysis revealed that male sex, the duration of diabetes, systolic BP, glycated hemoglobin and eGFR were significant independent factors associated with the presence of albuminuria, while advanced age, female sex, the duration of diabetes and urinary ACR were significant independent risk factors for RI. A significant proportion of T2DM patients with hypertension had albuminuria and RI, and the duration of diabetes mellitus rather than the duration of hypertension was a significant independent factor associated with albuminuria and RI.

AB - The prevalence of albuminuria is known to be higher in hypertensive compared to normotensive nondiabetic patients. In addition, systolic blood pressure (BP) is found to be an independent risk factor for albuminuria in type 2 diabetes mellitus (T2DM). Based on these findings, the prevalence of albuminuria is expected to be higher in T2DM with hypertension relative to T2DM without hypertension, but it has been largely unexplored. Prevalence rates of microalbuminuria, macroalbuminuria and renal insufficiency (RI) were investigated among 3738 hypertensive T2DM patients from 350 nationwide primary care clinics. Independent factors associated with albuminuria and RI were also characterized. Clinical and laboratory data of 3712 patients were included in the analysis. BP was controlled in only 1164 patients (31.4%). There were 2595 normoalbuminuric patients (70.6%), and microalbuminuria and macroalbuminuria were present in 850 (23.1%) and 230 (6.3%), respectively. The prevalence of RI was 32.1% based on estimated glomerular filtration rate (eGFR) by Modification of Diet in Renal Disease formula. Systolic BP correlated significantly with the natural logarithmic values of urinary albumin-to-creatinine ratio (ACR) (R = 0.16, P < 0.0001). Multivariate logistic regression analysis revealed that male sex, the duration of diabetes, systolic BP, glycated hemoglobin and eGFR were significant independent factors associated with the presence of albuminuria, while advanced age, female sex, the duration of diabetes and urinary ACR were significant independent risk factors for RI. A significant proportion of T2DM patients with hypertension had albuminuria and RI, and the duration of diabetes mellitus rather than the duration of hypertension was a significant independent factor associated with albuminuria and RI.

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DO - 10.1093/ndt/gfr011

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SN - 0931-0509

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