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Nefrología (Madrid)
versão On-line ISSN 1989-2284versão impressa ISSN 0211-6995
Resumo
LARANJINHA, Ivo et al. Diabetic kidney disease: Is there a non-albuminuric phenotype in type 2 diabetic patients?. Nefrología (Madr.) [online]. 2016, vol.36, n.5, pp.503-509. ISSN 1989-2284. https://dx.doi.org/10.1016/j.nefro.2016.03.025.
Background:
Albuminuria was widely considered as the first clinical sign of diabetic kidney disease (DKD), which is why it has traditionally been used as a screening test for DKD. However, increasing evidence has shown that a significant number of type 2 diabetes mellitus (DM) patients have a decreased glomerular filtration rate (GFR) without significant albuminuria, known as non-albuminuric DKD (NA-DKD). The aim of this study was to determine the prevalence and the demographic and clinical characteristics of patients with NA-DKD.
Methods:
This was a 1-year retrospective study that included 146 type 2 diabetic patients with GFR < 75 mL/min followed-up in a diabetes outpatient department. Patients were divided into two groups according to their ACR status - NA-DKD and albuminuric DKD (A-DKD).
Results:
Of the 146 patients included in the study, 53.4% had A-DKD and 46.6% had NA-DKD. According to the multivariable analysis performed, patients with NA-DKD tended to be older (p = 0.021), female (p = 0.045) and with a lower GFR (p = 0.004) than A-DKD patients.
There was no difference between the groups in terms of body mass index, metabolic control of DM, duration of DM diagnosis and prevalence of metabolic syndrome.
Conclusions:
The majority of patients with DKD had albuminuria, but a significant proportion had a non-albuminuric phenotype (46.6% in this population). These patients exhibit distinct clinical features that could have screening, therapeutic and prognosis implications.
Palavras-chave : Chronic kidney disease; Type 2 diabetes; Non-albuminuria.