A community-based study of chronic kidney disease among type 2 diabetics in Kinmen, Taiwan.

Diabetic nephropathy is the major cause of end-stage renal disease. Many studies show that chronic kidney disease can be prevented, or its progression to end-stage renal disease delayed, by effective intervention. The aim of this study was to estimate the prevalence of proteinuria and renal impairment in patients with type 2 diabetes. A community-based screening for chronic kidney disease in type 2 diabetic patients was conducted in 1999-2001. Proteinuria was defined in terms of urine protein-to-creatinine ratio. The glomerular filtration rate per 1.73m(2) body surface area was calculated using an equation from the Modification of Diet in Renal Disease Study. The overall response rate was about 78.6%. Prevalence rates of proteinuria and renal impairment were 29.4% and 15.1%, respectively. Females had higher prevalence of proteinuria and renal impairment than males. And prevalence increased with increasing age. Hypertension was associated with both proteinuria and renal impairment. Only 43.0% of patients with stages 3-5 chronic kidney disease had proteinuria. Proteinuria and renal impairment screening may identify different segments of the diabetic population. Both a glomerular filtration rate and proteinuria test are recommended as screening tools for early detection of chronic kidney disease in type 2 diabetics.