Prevalence and risk factors of albuminuria and chronic kidney disease in Chinese population with type 2 diabetes and impaired glucose regulation: Shanghai diabetic complications study (SHDCS)
- 17 July 2009
- journal article
- Published by Oxford University Press (OUP) in Nephrology Dialysis Transplantation
- Vol. 24 (12), 3724-3731
- https://doi.org/10.1093/ndt/gfp349
Abstract
Diabetes is a major risk factor for the development of kidney disease. We aimed to determine the prevalence of albuminuria and chronic kidney disease (CKD) in Chinese subjects with diabetes and pre-diabetes and the risk factors for kidney disease. An urban community-based sample of 3714 adults in Shanghai was classified into normal glucose tolerance (NGT), impaired glucose regulation (IGR) and diabetes. The estimated glomerular filtration rate (eGFR) and the urinary albumin-to-creatinine ratio (ACR) were applied to designate renal function and albuminuria, respectively. Binary logistic regression was performed to analyse the contribution of risk factors to CKD. Polynominal regression was used to determine the trends of eGFR with the increment of ACR. The prevalence of microalbuminuria, macroalbuminuria and CKD in subjects with diabetes was 22.8%, 3.4% and 29.6%, respectively, which was significantly higher than that in non-diabetes subjects. After adjustment for age, the odds ratio of hypertension for albuminuria and renal insufficiency (eGFR <60 mL/min/1.73 m(2,) stages 3-5 of CKD) were 1.23 (P = 0.000) and 2.55 (P = 0.000). Diabetes and cardiovascular disease (CVD) both increased the risk for albuminuria significantly, with the odds ratio of 1.22 (P = 0.04) and 1.36 (P = 0.006), respectively. Diabetes and CVD were not independent risk factor for renal insufficiency. Although the worsening trends of eGFR are similar in diabetes and IGR subjects, IGR was not a significant risk factor for albuminuria and renal insufficiency. Screening for albuminuria and eGFR is highly recommended for older patients with diabetes, hypertension and CVD to prevent end-stage kidney disease.Keywords
This publication has 31 references indexed in Scilit:
- Standards of Medical Care in Diabetes—2007Diabetes Care, 2007
- Epidemiological characteristics of diabetes mellitus and impaired glucose regulation in a Chinese adult population: the Shanghai Diabetes Studies, a cross-sectional 3-year follow-up study in Shanghai urban communitiesDiabetologia, 2006
- Screening strategies for chronic kidney disease in the general population: follow-up of cross sectional health surveyBMJ, 2006
- Progression of microalbuminuria in type 1 diabetes: Ten-year prospective observational studyKidney International, 2005
- Definition and classification of chronic kidney disease: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)Kidney International, 2005
- Predictors for the development of microalbuminuria and macroalbuminuria in patients with type 1 diabetes: inception cohort studyBMJ, 2004
- Kidney Disease as a Risk Factor for Development of Cardiovascular DiseaseHypertension, 2003
- Regression of Microalbuminuria in Type 1 DiabetesNew England Journal of Medicine, 2003
- Goodpasture syndrome during the course of a Schönlein-Henoch purpuraAmerican Journal of Kidney Diseases, 2002
- Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: Executive SummaryThe American Journal of Clinical Nutrition, 1998