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Normoalbuminuric kidney impairment in patients with T1DM: insights from annals initiative

BACKGROUND: We described, in a large sample of patients with type 1 diabetes mellitus (T1DM) and GFR ≤ 60 mL/min/1.73 m(2) (with or without albuminuria), the differences in the clinical features associated with the two different chronic kidney disease phenotypes and we investigated, in a subset of p...

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Autores principales: Lamacchia, Olga, Viazzi, Francesca, Fioretto, Paola, Mirijello, Antonio, Giorda, Carlo, Ceriello, Antonio, Russo, Giuseppina, Guida, Pietro, Pontremoli, Roberto, De Cosmo, Salvatore
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069993/
https://www.ncbi.nlm.nih.gov/pubmed/30083251
http://dx.doi.org/10.1186/s13098-018-0361-2
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author Lamacchia, Olga
Viazzi, Francesca
Fioretto, Paola
Mirijello, Antonio
Giorda, Carlo
Ceriello, Antonio
Russo, Giuseppina
Guida, Pietro
Pontremoli, Roberto
De Cosmo, Salvatore
author_facet Lamacchia, Olga
Viazzi, Francesca
Fioretto, Paola
Mirijello, Antonio
Giorda, Carlo
Ceriello, Antonio
Russo, Giuseppina
Guida, Pietro
Pontremoli, Roberto
De Cosmo, Salvatore
author_sort Lamacchia, Olga
collection PubMed
description BACKGROUND: We described, in a large sample of patients with type 1 diabetes mellitus (T1DM) and GFR ≤ 60 mL/min/1.73 m(2) (with or without albuminuria), the differences in the clinical features associated with the two different chronic kidney disease phenotypes and we investigated, in a subset of patients, the modulating role of albuminuria on kidney disease progression. METHODS: Clinical data of 1395 patients with T1DM were extracted from electronic medical records. RESULTS: Albuminuria was detected in 676 (48.5%) patients, with the remaining 719 (51.5%) patients having normoalbuminuric renal impairment. Those with albuminuria showed an evident worse cardiovascular risk profile as compared to patients with normoalbuminuria. A subgroup of 582 patients was followed up over a 4-year period. One hundred and twenty five patients (21.5%) showed a loss of eGFR > 30%. The proportion of patients reaching the renal outcome was significantly higher among those with baseline albuminuria as compared to patients with normoalbuminuria (P < 0.0001). At the multivariate logistic analysis microalbuminuria, macroalbuminuria and proliferative retinopathy were the only parameters independently associated to eGFR reduction. CONCLUSIONS: The proportion of T1DM patients with normoalbuminuria renal impairment is high (about 50%). These patients have a slower eGFR decline as compared to that observed in patients with albuminuria renal impairment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13098-018-0361-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-60699932018-08-06 Normoalbuminuric kidney impairment in patients with T1DM: insights from annals initiative Lamacchia, Olga Viazzi, Francesca Fioretto, Paola Mirijello, Antonio Giorda, Carlo Ceriello, Antonio Russo, Giuseppina Guida, Pietro Pontremoli, Roberto De Cosmo, Salvatore Diabetol Metab Syndr Research BACKGROUND: We described, in a large sample of patients with type 1 diabetes mellitus (T1DM) and GFR ≤ 60 mL/min/1.73 m(2) (with or without albuminuria), the differences in the clinical features associated with the two different chronic kidney disease phenotypes and we investigated, in a subset of patients, the modulating role of albuminuria on kidney disease progression. METHODS: Clinical data of 1395 patients with T1DM were extracted from electronic medical records. RESULTS: Albuminuria was detected in 676 (48.5%) patients, with the remaining 719 (51.5%) patients having normoalbuminuric renal impairment. Those with albuminuria showed an evident worse cardiovascular risk profile as compared to patients with normoalbuminuria. A subgroup of 582 patients was followed up over a 4-year period. One hundred and twenty five patients (21.5%) showed a loss of eGFR > 30%. The proportion of patients reaching the renal outcome was significantly higher among those with baseline albuminuria as compared to patients with normoalbuminuria (P < 0.0001). At the multivariate logistic analysis microalbuminuria, macroalbuminuria and proliferative retinopathy were the only parameters independently associated to eGFR reduction. CONCLUSIONS: The proportion of T1DM patients with normoalbuminuria renal impairment is high (about 50%). These patients have a slower eGFR decline as compared to that observed in patients with albuminuria renal impairment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13098-018-0361-2) contains supplementary material, which is available to authorized users. BioMed Central 2018-07-31 /pmc/articles/PMC6069993/ /pubmed/30083251 http://dx.doi.org/10.1186/s13098-018-0361-2 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Lamacchia, Olga
Viazzi, Francesca
Fioretto, Paola
Mirijello, Antonio
Giorda, Carlo
Ceriello, Antonio
Russo, Giuseppina
Guida, Pietro
Pontremoli, Roberto
De Cosmo, Salvatore
Normoalbuminuric kidney impairment in patients with T1DM: insights from annals initiative
title Normoalbuminuric kidney impairment in patients with T1DM: insights from annals initiative
title_full Normoalbuminuric kidney impairment in patients with T1DM: insights from annals initiative
title_fullStr Normoalbuminuric kidney impairment in patients with T1DM: insights from annals initiative
title_full_unstemmed Normoalbuminuric kidney impairment in patients with T1DM: insights from annals initiative
title_short Normoalbuminuric kidney impairment in patients with T1DM: insights from annals initiative
title_sort normoalbuminuric kidney impairment in patients with t1dm: insights from annals initiative
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069993/
https://www.ncbi.nlm.nih.gov/pubmed/30083251
http://dx.doi.org/10.1186/s13098-018-0361-2
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