Diabetic kidney disease: Is there a non-albuminuric phenotype in type 2 diabetic patients?

Laranjinha, Ivo; Matias, Patrícia; Mateus, Sofia; Aguiar, Filipa; Pereira, Patrícia Feliciano; Santos, Miguel Perneta; Costa, Rui M. Gil da; Lourenço, Ana P.; Guia, José; Barata, José Diogo; Campos, Luís

doi:10.1016/j.nefro.2016.03.025

Cited by 24 publications

(21 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We also found that albuminuria was absent in 31.8% of subjects with CKD stages 3 to 5 (eGFR < 60 ml/min/1.73m 2 ). In line with this a recent study found that approximately one half (46.6%) of diabetics with CKD had reduced eGFR without albuminuria [33]. Inadequacies of CKD diagnosis in diabetes from routine clinical assessment also are mentioned frequently in the literature [11,12,31], indicating the need for a simple functional measurement of GFR, as provided using the eGFR.…”

Section: Discussionmentioning

confidence: 73%

Prevalence and awareness of chronic kidney disease among adult diabetic outpatients in Northeast Ethiopia

Fiseha

Tamir

2020

BMC Nephrol

View full text Add to dashboard Cite

Background: Chronic kidney disease (CKD) is a serious complication of diabetes associated with adverse outcomes of renal failure, cardiovascular disease and mortality. Despite this, data regarding the burden and awareness of CKD among adults with diabetes in Sub-Saharan Africa countries are lacking. The aim of this study was, therefore to determine the prevalence and awareness of CKD among diabetic outpatients attending a hospital in Northeast Ethiopia. Methods: We conducted a cross-sectional study on 323 diabetic adults at the diabetes clinic of a hospital in Northeast Ethiopia, from February 1 to July 30, 2016. Each patient provided a blood sample for serum creatinine and urine for albuminuria. Glomerular filtration rate (eGFR) was estimated using the Modification of Diet in Renal Disease (MDRD) equation. CKD was defined as eGFR < 60 ml/min/1.73 m 2 and/or albuminuria. Awareness was defined as a positive response to "Has a doctor or other health care professional ever told you that you had kidney disease?" Results: Of the 323 patients, 85 (26.3%) had Stage 1-5 CKD, 42 (13.0%) had eGFR < 60 ml/min/1.73m 2 and 58 (18.0%) had albuminuria. In patients with eGFR < 60 ml/min/1.73m 2 (stage 3-5 CKD), serum creatinine was abnormal (> 1.5 mg/dl) in 23.5% and albuminuria was absent in 31.8%. Of the patients with CKD, only 10.6% of them were aware of their CKD. The proportion of patients who were aware of their disease increased with worsening of CKD stages, from 3.4% of with stage 1 to 75.0% with stage 4. Awareness for all individuals with advanced stages of CKD was only 11.9%. Having albuminuria, high serum creatinine, a family history of kidney disease and being obese were significantly associated with CKD awareness. Conclusion: A high prevalence but low awareness of CKD was found in diabetic outpatients attending our clinic in Northeast Ethiopia. Our results highlight the need for more diagnostic strategies for CKD screening among diabetic adults and primary care education on the impact of detecting CKD in the early stage to prevent adverse outcomes and improve diabetes care.

show abstract

Section: Discussionmentioning

confidence: 73%

Prevalence and awareness of chronic kidney disease among adult diabetic outpatients in Northeast Ethiopia

Fiseha

Tamir

2020

BMC Nephrol

View full text Add to dashboard Cite

show abstract

“…En cambio, la etiología de la ERD-NA en diabéticos tipo 2 podría ser más variable. Desafortunadamente, aunque la ERD-NA en diabéticos tipo 2 ha sido descrita en una gran variedad de estudios, en ellos se hace diferenciación respecto a características clínicas y hábitos entre su condición normoalbuminúrica vs. microalbuminuria o macroalbuminuria, sin recurrir a la biopsia renal para obtener un diagnostico definitivo [2][3][4][5][6][7] .…”

Section: Discussionunclassified

“…La prevalencia de esta enfermedad [2][3][4] varía entre 25 % a 50 % de los pacientes que exhiben TFG menor a 60 ml/min/1,73mt2. Los pacientes con ERD-NA presentan características diferentes a la población albuminúrica, tales como: mayor proporción de sexo femenino, edad mayor, menor TFG, buen control de la presión arterial, raza blanca no hispanos, menor prevalencia de tabaquismo y mayor prevalencia de polineuropatía [5][6][7] .…”

Section: Introductionunclassified

Características clínicas de una población de diabéticos tipo 2 con alteración en la función renal no macroalbuminúricos

Gómez

Valencia

Arango

2017

Rev. Colomb. Nefrol.

View full text Add to dashboard Cite

OriginalCaracterísticas clínicas de una población de diabéticos tipo 2 con alteración en la función renal no macroalbuminúricos ResumenAntecedentes: aunque la principal causa de deterioro en la función renal en pacientes diabéticos es la nefropatía diabética (ND), existen otras causas que siempre se deben investigar, especialmente cuando en ellos no se detecta macroalbuminuria. Objetivo: caracterización de variables demográficas, clínicas y etiológicas encontradas en una población de diabéticos tipo 2 de más de 10 años de evolución, no macroalbuminúricos, con elevación de azoados. Métodos: se identificaron 67 pacientes, en los cuales se practicaron diversos estudios imagenológicos para lograr un diagnostico etiológico. Si los estudios no fueron concluyentes, se procedió a practicar biopsia renal percutánea Resultados: la media de edad fue de 73,4 años (DE: 9,3). Media de creatinina 1,8 mg/dl, 50,75 % de los pacientes presentaron albuminuria normal (A1) y 49,3 % albuminuria moderadamente incrementada (A2). En 28 pacientes se obtuvo diagnósticos por imágenes, siendo la nefropatía hipertensiva el principal hallazgo. Se practicó biopsia renal al 58,20 % de la población (39 pacientes) y, en ellos, los diagnósticos fueron: ND aislada en el 28 % de los casos (11 pacientes), nefroesclerosis hipertensiva 28 % (11 pacientes), nefropatía mixta (diabética e hipertensiva) 18 % (7 pacientes), nefropatía por IgA 5 % (2 pacientes). Conclusiones: la nefropatía hipertensiva es la principal causa de elevación de azoados en diabéticos tipo 2 no macroalbuminúricos. La ND aislada sólo explica el 16,42 % (11 pacientes) de las causas de esta población.Palabras clave: nefropatías, diabetes mellitus, albuminuria, biopsia con aguja.doi: http://dx.doi.org/10.22265/acnef.4.2.271Abstract Background: The main cause of impaired renal function in diabetic patients is diabetic nephropathy (ND), but there are other causes that should always be investigated especially when they do not detect macroalbuminuria. Aims: Characterization of demographic, clinical and etiological variables found in a population of type 2 diabetics over 10 years of non-macroalbuminuric evolution with nitrogen products elevation. Methods: We identified 67 patients, in whom several imaging studies were performed to obtain an etiological diagnosis. If the studies were inconclusive, percutaneous renal biopsy was performed. Results: The mean age was 73.4 years (SD: 9.3). Mean creatinine 1.8 mg / dl, 50.75% of the patients had normal albuminuria (A1) and 49.3% moderately increased albuminuria (A2). In 28 patients, imaging diagnoses were obtained, with hypertensive nephropathy being the main finding. A total of 58.20% (39 patients) of the population were submitted to renal biopsy. ND was detected in the 28% of cases (11 patients), hypertensive nephrosclerosis 28% (11 patients), mixed nephropathy (diabetic and hypertensive) 18% (7 patients), 5% IgA nephropathy (2 patients).Conclusions: Hypertensive nephropathy is the main cause of elevated nitrogen products in non-macroalbuminuri...

show abstract

“…The reported prevalence of DN varies widely worldwide. It is generally thought that the clinical onset of DN is characterized by the presence of micro-albuminuria or reduction in estimated glomerular filtration rate (eGFR) (Kramer et al, 2003;Pavkov et al, 2012;Shimizu et al, 2014;Laranjinha et al, 2016;Cameron, 2016). However, an autopsy study recently found the absence of micro-albuminuria in some patients with biopsy-proven DN (Klessens et al, 2016), which reminds us that a relative part of DN was clinically under-diagnosed.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, Other studies of renal biopsy in DM have documented that non-diabetic renal disease (NDRD) plays a significant role in diabetic patients. The reported proportion of NDRD alone ranges from 18.1%-82.9% (Pavkov et al, 2012;Byun et al, 2013;Sharma et al, 2013;Zhuo et al, 2013;Horvatic et al, 2014;Zwi et al, 2014;Klessens et al, 2016;Laranjinha et al, 2016;Liu, Tian & Jian, 2016) in diabetic patients with renal disease, while that of NDRD superimposed on DN ranges from 7.8%-48.9% (Oh et al, 2012;Pavkov et al, 2012;Byun et al, 2013;Zhuo et al, 2013;Horvatic et al, 2014;Zwi et al, 2014;Klessens et al, 2016;Laranjinha et al, 2016;Liu, Tian & Jian, 2016). It is suggested that the absence of histopathologic evaluation may lead to a relatively high proportion of NDRD that were misdiagnosed as DN among diabetic patients.…”

Section: Introductionmentioning

confidence: 99%

Peer Review #1 of "The modern spectrum of biopsy-proven renal disease in Chinese diabetic patients—a retrospective descriptive study (v0.1)"

2018

View full text Add to dashboard Cite

Diabetic kidney disease: Is there a non-albuminuric phenotype in type 2 diabetic patients?

Abstract: 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.

Cited by 24 publications

References 34 publications

Prevalence and awareness of chronic kidney disease among adult diabetic outpatients in Northeast Ethiopia

Prevalence and awareness of chronic kidney disease among adult diabetic outpatients in Northeast Ethiopia

Características clínicas de una población de diabéticos tipo 2 con alteración en la función renal no macroalbuminúricos

Peer Review #1 of "The modern spectrum of biopsy-proven renal disease in Chinese diabetic patients—a retrospective descriptive study (v0.1)"

Contact Info

Product

Resources

About