Systolic blood pressure as a predictor of incident albuminuria and rapid renal function decline in type 2 diabetic patients

作者：Sheen Yi Jing; Lin Jiann Liang; Li Tsai Chung; Bau Cho Tsan; Sheu Wayne H H^*

来源：Journal of Diabetes and Its Complications, 2014, 28(6): 779-784.

DOI：10.1016/j.jdiacomp.2014.08.002

• Type 2 diabetes
• Systolic blood pressure
• Urine albumin-to-creatinine ratio
• Estimated glomerular filtration rate
• Rapid decline

Aims: Albuminuria and a reduced estimated glomerular filtration rate (eGFR) are known risk factors of poor cardiovascular outcomes in diabetic patients. We here aimed to investigate the determinants of incident albuminuria and rapid progression of renal dysfunction in patients with type 2 diabetes. %26lt;br%26gt;Methods: Type 2 diabetic outpatients (n = 215) with a mean baseline eGFR of 87 +/- 20 mL min(-1) 1.73 m(-2) were followed for 12 months. Urinary albuminuria was defined according to the urine albumin-to-creatinine ratio (UACR). %26lt;br%26gt;Results: Among 132 patients with normoalbuminuria at baseline, 20 (15.2%) progressed to a more advanced stage of albuminuria within 1 year, and 20.5% of the 215 patients experienced a rapid decline in eGFR (eGFR reduction %26gt;5 mL min(-1) 1.73 m(-2) year(-1)). After adjusting for potential confounders, both baseline UACR and systolic blood pressure (SBP) were found to be significant independent factors for incident albuminuria and a rapid decline of eGFR in separate models. Using receiver operating characteristic curves, systolic blood pressures of 132 and 138 mmHg were found to predict incident albuminuria and a rapid decline of eGFR, respectively. %26lt;br%26gt;Conclusions: In addition to baseline UACR, SBP is one of the most powerful modifiable independent risk factors for incident albuminuria and a rapid renal function decline in type 2 diabetic patients without symptomatic cardiovascular disease.

• 出版日期2014-12
• 单位河北医科大学; 中国医科大学