Endocrinol Metab.  2016 Dec;31(4):577-585. 10.3803/EnM.2016.31.4.577.

Prevalent Rate of Nonalbuminuric Renal Insufficiency and Its Association with Cardiovascular Disease Event in Korean Type 2 Diabetes

• Lee HW
• Jo AR
• Yi DW
• Kang YH
• Son SM

• KMID: 2373078
• DOI: http://doi.org/10.3803/EnM.2016.31.4.577

Abstract

BACKGROUND
Nonalbuminuric renal insufficiency is a unique category of diabetic kidney diseases. The objectives of the study were to evaluate prevalent rate of nonalbuminuric renal insufficiency and to investigate its relationship with previous cardiovascular disease (CVD) event in Korean patients with type 2 diabetes mellitus (T2DM).
METHODS
Laboratory and clinical data of 1,067 subjects with T2DM were obtained and reviewed. Study subjects were allocated into four subgroups according to the CKD classification. Major CVD events were included with coronary, cerebrovascular, and peripheral vascular events.
RESULTS
Nonalbuminuric stage ≥3 CKD group, when compared with albuminuric stage ≥3 CKD group, had shorter diabetic duration, lower concentrations of glycated hemoglobin, high density lipoprotein cholesterol, and high-sensitivity C-reactive protein, lower prevalent rates of retinopathy and previous CVD, and higher rate of treatment with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers. Nonalbuminuric stage ≥3 CKD group showed a greater association with prior CVD events than no CKD group; however, albuminuric stage ≥3 CKD group made addition to increase prevalence of prior CVD events significantly when CKD categories were applied as covariates. Association of prior CVD events, when compared with normal estimated glomerular filtration rate (eGFR) and nonalbuminuria categories, became significant for declined eGFR, which was higher for eGFR of <30 mL/min/1.73 m², and albuminuria.
CONCLUSION
The results show that subjects with nonalbuminuric stage ≥3 CKD is significantly interrelated with occurrence of prior CVD events than those with normal eGFR with or without albuminuria. Comparing with normal eGFR and nonalbuminuria categories, the combination of increased degree of albuminuria and declined eGFR is becoming significant for the association of prior CVD events.

Keyword

Nonalbuminuric renal insufficiency; Diabetes mellitus; Cardiovascular diseases

MeSH Terms

Albuminuria
C-Reactive Protein
Cardiovascular Diseases*
Cholesterol, HDL
Classification
Diabetes Mellitus
Diabetes Mellitus, Type 2
Diabetic Nephropathies
Glomerular Filtration Rate
Hemoglobin A, Glycosylated
Humans
Prevalence
Renal Insufficiency*
C-Reactive Protein
Cholesterol, HDL

Figure

• 

  Fig. 1 Prevalence of non-, micro-, and macroalbuminuria according to classes of estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease (MDRD) study and the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) formulas.

• 

  Fig. 2 Prevalence of (A) previous cardiovascular disease (CVD) and (B) retinopathy according to degree of albuminuria and classes of estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease study equation.

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