Clinic Investigate And Dialysis Of Diabetic Nephropathy In Type 2 Diabetes

Background and Objective: Diabetic nephropathy (DN) is the leading cause of end-stage renal diseases (ESRD) in developed countries and it is rapidly becoming the leading cause in developing countries as a consequence of the global increase in type 2 diabetes mellitus(DM). DN is the second cause of ESRD in our countries. It was reported that multiple factors were attributed to the development of DN, but short of relative data in the locality of Guizhou. The aim of this study was investigation the clinic feature and risk factors of DN in patients with type 2 DM. We hope that the result can provide some evidence for clinic practice in prevention and treatment of DN. Method: The information on 1384 cases of hospitalized patients with type 2 DM from 2006 to 2008 in affiliated hospital of Zunyi Medical college were collected. They were staged according urine albumin excretion rate (UAER) and glomerular filtration rate (GFR).The clinic feature and risk factors of DN in type 2 DM were retrospectively analyzed. Results: Prevalence rate of diabetic nephropathy is 56% and diabetic kidney disease (DKD) is 61%, but there is not significantly different among both figure. There are 14.9% patients whose UAER lower 30 mg/24 hours are the stage of chronic kidney disease (CKD) 3-4. Less than 50% patients take the ACEI or ARB and low protein diet when they occurred albuminuria, and less than 30% patients consult the renal physicians. More than 90% diabetic nephropathy patients need emergent dialysis when they are shifted to renal physicians. Age, course of disease, proportion of the smoking, body mass index, glycosylated hemoglobin, systolic and diastolic blood pressure and complications are significantly different among four diabetic subgroups(p < 0.05). Age, course of disease, systolic blood pressure have significant positive effect on the incidence of diabetic nephropathy (p<0.05). Conclusions: Multidisciplinary intervention is necessary for DN management on account of high prevalence rate and increasing complications in type 2 DM with albuminuria. The screening evaluation for DN ought to detect UAER and GFR. Age, course of disease, systolic blood pressure have significant positive effect on theincidence of diabetic nephropathy.