Néphropathie chez les diabétiques type 2 : aspects évolutifs et facteurs prédictifs

INTRODUCTION : Diabetic nephropathy (DN) is the most common cause of end-stage renal disease. AIM: To study the evolution of nephropathy in a group of type 2 diabeticsin order to determine the predictive factors of progression. METHODS : We conducted a longitudinal retrospective, descriptive study involved 100 type 2 diabetics patients with confirmed DN for at least 10 years. The patients were divided into 2 groups according to the evolution of their DN: stable DN (group 1) and progressive DN (group 2). RESULTS : :At the time of diagnosis of DN, the majority (82%) of the patients were in the stage of incipient DN while 18% were in the stage of established DN.Univariate regression analysis showed that higher baseline values of albuminuria (p=0.038),creatinine (p equal to 0.001), systolic blood pressure (p=0.009), uricemia (p=0.01) as well as a lower glomerular filtration rate (GFR) (p less than 0.001) and smoking (p = 0.023) were significantly associated with an unfavorable evolution of DN.A high mean value during monitoring in albuminuria (p less than 0.001), creatinine (p less than 0.001), systolicblood pressure (p less than 0.001), uric acid (p less than 0.001) as well as a lower GFR (p less than 0.001) and a higherfrequency of hypertriglyceridemia (p equal to 0.004) were considered to be risk factors for anunfavorable development of DN detectable during follow-up. CONCLUSION : We have found several predictors of progression of DN in our work whose multifactorial approachcould improve the outcome of our patients as well as their quality of life.