Remission of diabetic nephropathy in type 2 diabetic Asian population: role of tight glucose and blood pressure control.

Abstract

BACKGROUND:

Asian has higher prevalence of diabetic nephropathy (DN) and end-stage renal disease when compared to Caucasian. No study to date has evaluated whether multifactorial intervention was associated with remission of microalbuminuria in type 2 diabetic Asian population. We evaluated the effect of tightly controlling multiple factors on the remission of DN in type 2 diabetic Chinese with microalbuminuria.

MATERIALS AND METHODS:

A longitudinal cohort study was collected 587 type 2 diabetic patients with microalbuminuria. Cohort members received intensified treatment to meet the following ADA recommended goals: HbA1c <7%, systolic blood pressure (SBP) <130mmHg, diastolic blood pressure <80 mmHg, low-density lipoprotein cholesterol <100mgdL(-1) , triglyceride < 150mgdL(-1) , high-density lipoprotein cholesterol >40mgdL(-1) for men and >50mgdL(-1) for women. Remission of microalbuminuria was defined as shift of albumin-creatinine ratio from mircoalbuminuria to normoalbuminuria.

RESULTS:

During the 4·5-year period, 210 (35·8%) patients achieved remission to normoalbuminuria. A significant association was found between the achievement of ADA goals, including HbA1c < 7% [hazard ratio (HR)=1·345; 95% confidence interval (CI), 1·010-1·792; P=0·04] and SBP <130mmHg (HR, 1·516; 95% CI, 1·100-2·089; P=0·01) and remission of microalbuminuria. The intensive SBP control (<120mmHg) was significantly associated with remission of microalbuminuria (HR, 2·076; 95% CI, 1·347-3·198; P<0·001).

CONCLUSIONS:

The remission of DN could be achieved under multifactorial intervention. Therapeutic focus on remission by tight glycemic and blood pressure control should be considered in Asian population with diabetes and microalbuminuria.

• Authors: Ming-Chia Hsieh, Yi-Ting Hsieh, Tzu-Jung Cho, Jung-Fu Chen, Shi-Dou Lin, Hung-Chun Chen, Shih-Te Tu
• Journal: European journal of clinical investigation (Eur J Clin Invest) Vol. 41 Issue 8 Pg. 870-8 (Aug 2011) ISSN: 1365-2362 [Electronic] England
• PMID: 21299554 (Publication Type: Journal Article)
• Copyright: © 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation.

Chemical References

• Antihypertensive Agents
• Blood Glucose
• Hypoglycemic Agents

Topics

• Aged
• Albuminuria (drug therapy)
• Antihypertensive Agents (therapeutic use)
• Asian People (genetics)
• Blood Glucose (physiology)
• Blood Pressure (drug effects)
• Cohort Studies
• Diabetes Mellitus, Type 2 (blood, drug therapy, genetics)
• Diabetic Nephropathies (blood, genetics, prevention & control)
• Female
• Humans
• Hypoglycemic Agents (therapeutic use)
• Longitudinal Studies
• Male
• Middle Aged
• Remission Induction (methods)