Kuspuji Triyanti1, Pradana Soewondo, Hamzah Shatri. 1. Department of Internal Medicine, Faculty of Medicine, University of Indonesia-dr, Cipto Mangunkusumo Hospital, Jakarta Pusat. triyanti.k@gmail.com
Abstract
AIM: to screen for reduction of renal function in type 2 diabetes mellitus (DM) patients based on various estimated Glomerular Filtration rate (eGFR). METHODS: 1283 newly registered type 2 DM patients were included in the study room from the year 2003 until 2006. We calculated the eGFR by the Cockroft-Gault (CG), Cockroft-Gault adjusted for body surface area (CG-BSA), 4-variables Modification of Diet in Renal Disease (MDRD), and Chinese adapted MDRD (C-MDRD) methods based on serum creatinine. We also investigated the significant risk factors based on the method with the highest percentage of renal dysfunction. RESULTS: type 2 DM patients with serum creatinine > or = 2 mg/dL (the abnormal limit in Indonesia) was only 5.8%, but the prevalence of patients with eGFR<60mL/mnt was 36.1% (CG), 43.7% (CG-BSA), 13.2% (MDRD), or 22.8% (C-MDRD). We used CG-BSA to determine risk factors as the highest method with highest percentage of renal dysfunction. Significant risk factors for renal dysfunction based on multivariate analysis were history of hypertension (P=0.025, 95%Cl 1.08-3.19), proteinuria (P=0.015, 95%Cl 1.13-3.22), and diabetic retinopathy (P=0.001, 95% Cl 1.43-4.20). CONCLUSION: the use of eGFR is recommended to screen in type 2 DM patients than the use of mere serum creatinine. We advocate the use of CG-BSA method to increase the physician's awareness, as more subjects will fall within the ambit of CKD.
AIM: to screen for reduction of renal function in type 2 diabetes mellitus (DM) patients based on various estimated Glomerular Filtration rate (eGFR). METHODS: 1283 newly registered type 2 DMpatients were included in the study room from the year 2003 until 2006. We calculated the eGFR by the Cockroft-Gault (CG), Cockroft-Gault adjusted for body surface area (CG-BSA), 4-variables Modification of Diet in Renal Disease (MDRD), and Chinese adapted MDRD (C-MDRD) methods based on serum creatinine. We also investigated the significant risk factors based on the method with the highest percentage of renal dysfunction. RESULTS: type 2 DMpatients with serum creatinine > or = 2 mg/dL (the abnormal limit in Indonesia) was only 5.8%, but the prevalence of patients with eGFR<60mL/mnt was 36.1% (CG), 43.7% (CG-BSA), 13.2% (MDRD), or 22.8% (C-MDRD). We used CG-BSA to determine risk factors as the highest method with highest percentage of renal dysfunction. Significant risk factors for renal dysfunction based on multivariate analysis were history of hypertension (P=0.025, 95%Cl 1.08-3.19), proteinuria (P=0.015, 95%Cl 1.13-3.22), and diabetic retinopathy (P=0.001, 95% Cl 1.43-4.20). CONCLUSION: the use of eGFR is recommended to screen in type 2 DMpatients than the use of mere serum creatinine. We advocate the use of CG-BSA method to increase the physician's awareness, as more subjects will fall within the ambit of CKD.
Authors: Young Hwangbo; Virginia M Weaver; Maria Tellez-Plaza; Eliseo Guallar; Byung-Kook Lee; Ana Navas-Acien Journal: Environ Health Perspect Date: 2011-08-11 Impact factor: 9.031