부산대학교 도서관

Low glomerulare filtration rate (GFR) is a predictor of ESRD and cardiovascular (CV) events. Aim of this study was to evaluate correlates of low GFR and its relationship with established CV risk factors among non-proteinuric individuals with DM2. The study involved 55 Italian diabetes outpatient clinics that selected a random sample of patients aged 18-80 years. A morning spot urine sample was collected to measure albumin/creatinine ratio (ACR) and to detect urinary infections. GFR was calculated with the MDRD formula. Out of 1362 patients, 1160 were included in the analyses, while 202 were excluded due to the presence of urinary infections and/or macroalbuminuria. The prevalence of low GFR (<60 ml/min/1.73 m²) was of 10.6%. Overall, 4% of the patients had both MA (ACR=30-299 mg/g) and low GFR, 15% had MA but not low GFR, and 7% had low GFR but not MA. Correlates of low GFR were investigated using a stepwise logistic regression. The likelihood of low GFR increased with longer diabetes duration (OR=1.05, 95%IC 1.02-1.07); it was also increased in non-smokers (OR=2.3, 95%IC 1.5-3.7), in patients with previous CV event (OR=2.5, 95%IC 1.6-3.9), and in those with MA (OR=2.3, 95%IC 1.5-3.5). Patients treated with ACE-Inhibitors and/or ARBs also showed an increased likelihood of low GFR (OR=2.1, 95%IC 1.4-3.3), probably as a consequence of indication bias. In conclusion, low GFR is present in one out of ten diabetic patients and its likelihood increases with diabetes severity. The presence of low GFR should be systematically checked, particularly in the presence of MA. [ABSTRACT FROM AUTHOR]