Traditional and Non-traditional Clinical and Biochemical Risk Factors for Altered Kidney Function in Type II Diabetes mellitus Patients

Abstract

Background:Exploring the risk factors associated with increased albumin excretion is necessary in patients with type 2 diabetes mellitus, due to the fact that such patients are exposed to an increased risk of progression to diabetic kidney disease and that non-traditional newly emerging factors could be corrected in order to reduce the progression rate. Material and methods:218 patients with type 2 diabetes mellitus were investigated regarding their urinary albumin/creatinine ratio. Clinical and laboratory data was collected from them, with biochemical investigations including serum uric acid and serum 25-hydroxi-vitamin D (25-OH-vitamin D) measurements. The prevalence of traditional and non-traditional risk factors for increased albumin excretion rate (albumin/creatinine ratio>30 mg/g), hyperuricemia and 25-OH-vitamin D deficiency, was determined after dividing patients into two groups, one with microalbuminuria and the other one with micro- or macroalbuminuria. Results:Of all patients, 104 (47.93%) had microalbuminuria, while 9.22% (20) presented macroalbuminuria. Poor glucose control (HbA1c .7%), female sex, hyperuricemia (uric acid .7 mg/dL), vitamin D deficiency (25-OH-vitamin D .50 nmol/L), hypertension (systolic hypertension or diastolic hypertension or hypertension treatment) and hypertriglyceridemia (triglycerides .150 mg/dL) had a statistically significant higher prevalence (p<0.05) in the 124 patients with microalbuminuria or macroalbuminuria compared to the 94 subjects wit normaoalbuminuria. Conclusion:Glucose control, hypertension and dyslipidemia are relevant traditional risk factors for an altered kidney function defined as urinary albumin/creatinine ratio >30 mg/g. However, hyperuricemia and 25-OH-vitamin D deficiency are long time ignored factors that could play an important role in the progression towards diabetic kidney disease.

TABLE 1.

Patient clinical characteristics

TABLE 2.

Clinical and biochemical differences according to creatine ratio

FIGURE 1.

Prevalence of cardiovascular risk factors among patients with and without increased albumin excretion