Clinical Characteristics And Regularity For Development Of CKD In Middle-aged And Old Patients With Type 2 Diabetes

Objective1,To determine the clinical characteristics and risk factors of CKD.2,To evaluate risk factors for development of CKD in middle-aged and old patients with type 2 diabetes and to explore the outcome and regularity of CKD progression.Material and Methods:1,245 patients,over 50 years old,with type 2 diabetes who were admitted to PLA General Hospital between 2000 and 2008 were studied.2,The patients were divided into CKD groupand control,group based on K/DOQI. Clinical characteristics were evaluated among the two groups.3,The patients were divided into 8 groups according to their serum creatinine (normal,high)and urine protein(normal,microalbuminuria,macroalbuminuria).The trend of the level ofGFR,SCr,BUN and RBC was obtained by correlation analysis. Also,we can get the relativity of the groups and CKD stages.4,The risk factors and regularity of the development of serum creatinine and GFR were studied by correlation analysis and establishing regression equation.Results1,In the CKD group,age,SCr,BUN,Ua,TG,LP(a),CA19-9,CA15-3 levels and SBP,DBP,ECG abnormality,the morbidity rate of hypertension were higher,whine GFR,RBC,HB and serum iron levels were lower than those in the control group(p ＜0.05).Hypertension,diastolic pressure,serum CA19-9 were the risk factors of CKD through the Logistic Analysis.2,There was a linear correlation between SCr,BUN,Ua,GFR,RBC,HB,CA19-9,CA15-3,urine protein of 24h,SBP,ECG abnormality and CKD stages.3,There was about 30%normoalbuminufic patients in CKD.1,2 and 3 stages. Almost all of the patient' serum creatinine was normal in CKD1,2 stages.4,There was a linear correlation between SCr,BUN,HBP,GFR,RBC,HB,CKD Stage and the groups divided according to their serum creatinine and urine protein.5,There was positive correlation between TP,UA,TG,LP(a),ACR,UAE,DR,CI,smoke and SCr' progression.There was negative correlation between SCr,BUN,P,Mg and SCr' progression(p＜0.05).Stepwise regression analysis:There was a visible linear correlation between ACR,Cr,CA15-3 and SCr'progression.Conclusion1,There is a significant statistical relationship between hypertension,hyperlipemia,hyperuricacidemia,age,CA19-9,red blood cell,hemoglobin,serum iron and CKD in middle-aged and old patients with type 2 diabetes.Hypertension and CA19-9 are the risk factors of CKD.2,The group with high level serum creatinine and macroalbuminuria has higher CKD stage,and its prognosis is worse,development is faster.3,UA,TG,LP(a),SCr,BUN,CA15-3,Urine protein,smoke and the course of hypertension contribute to the progression of CKD,When SCr＜159μmol/l,eGFR＞50 ml/min,the development of eGFR is ouick.