Abstract | BACKGROUND: METHOD: We conducted a 2-year study in patients with type 2 diabetes with estimated glomerular filtration rate (eGFR) greater than or equal to 40 ml/mmin/1.73 m² and urinary albumin- creatinine ratio (ACR) greater than or equal to 40 mg/mmol to evaluate a community-based programme aimed at optimising BP. Primary outcomes included BP reduction, remission of albuminuria and change in eGFR. RESULTS: Thirty-nine of 47 patients completed greater than or equal to 17 months of intervention. The mean age was 53 plus or minus 8 years; 77% were male. An increase in antihypertensive therapy intensity was accompanied by a median (IQR) reduction in BP of 13[-1.5-22.5)/ 12(1-19) mmHg p<0.05] and urinary ACR (51(20-97) vs. 126(65-194) mg/mmol, p<0.05). Twelve (28%) of 43 patients achieving remission of albuminuria had a faster eGFR loss in the first year compared to the non-remitting group [13.6(4.0-16.6) vs. 3.5(-0.97-7.5) ml/min/1.73 m²/year, (p=0.02), but the rate of loss slowed in the second year. Two patients reached ESRF. CONCLUISON: This community-based programme was effective in lowering BP and urinary ACR. In patients who achieved remission of albuminuria, a slower eGFR decline was observed after 12 months.
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Authors | Jasmine Tan, Fifita McCready, Fiona Noovao, Oketi Tepueluelu, John Collins, Tim Cundy |
Journal | The New Zealand medical journal
(N Z Med J)
Vol. 127
Issue 1404
Pg. 17-26
(Oct 17 2014)
ISSN: 1175-8716 [Electronic] New Zealand |
PMID | 25331308
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adolescent
- Adult
- Aged
- Algorithms
- Antihypertensive Agents
(therapeutic use)
- Diabetes Mellitus, Type 2
(complications, ethnology)
- Diabetic Nephropathies
(ethnology, etiology)
- Disease Progression
- Female
- Humans
- Hypertension
(drug therapy, ethnology)
- Induction Chemotherapy
(methods)
- Male
- Middle Aged
- New Zealand
- Primary Health Care
- Prospective Studies
- Risk Factors
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