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  • Title: Cardiovascular risk factors and complications associated with albuminuria and impaired renal function in insulin-treated diabetes.
    Author: Doggen K, Nobels F, Scheen AJ, Van Crombrugge P, Van Casteren V, Mathieu C.
    Journal: J Diabetes Complications; 2013; 27(4):370-5. PubMed ID: 23537603.
    Abstract:
    AIMS: To establish the association between albuminuria and cardiovascular risk factors as well as micro- and macrovascular complications in type 1 and insulin-treated type 2 diabetes, both in the presence and in the absence of reduced estimated glomerular filtration rate (eGFR). METHODS: Cross-sectional study including 7640 insulin-treated diabetic patients (33% type 1) treated in specialist diabetes centers. Albuminuria was defined as ≥30 mg/g, 20 mg/L, 20 μg/min or 30 mg/24 h. Reduced eGFR was defined as <60 mL/min/1.73 m(2) (CKD-EPI equations). RESULTS: Albuminuria, reduced eGFR or a combination was more prevalent in type 2 (21.5%, 15.9% and 16.5%) than in type 1 diabetes (16.1%, 4.7% and 4.0%, all P < 0.001 vs. type 2). Albuminuria was associated with poorer control of blood pressure, blood lipids and glycemia as well as higher prevalence of retinopathy and macrovascular disease, regardless of preserved/reduced eGFR or diabetes type. Reduced eGFR was associated with higher prevalence of micro- and macrovascular complications especially in type 2 diabetes. Combined presence of albuminuria and reduced eGFR was associated with the worst cardiovascular outcomes. CONCLUSIONS: Albuminuria and impaired renal function are prevalent in type 1 and insulin-treated type 2 diabetes. Albuminuria, but also normoalbuminuric renal impairment, is associated with micro- and macrovascular complications.
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