Po-Ya Chang1, Li-Nien Chien2, Yuh-Feng Lin3, Wen-Ta Chiu4, Hung-Yi Chiou5. 1. School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan. 2. School of Health Care Administration, Taipei Medical University, Taipei, Taiwan. 3. Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan. 4. Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan. 5. School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan. Electronic address: hychiou@tmu.edu.tw.
Abstract
BACKGROUND AND AIM: Hyperglycemic, hypertension, and lipid abnormalities are risk factors for diabetic kidney disease However, no study has discussed the association of the simultaneous control of glycemic, blood pressure, and lipids with renal function among diabetes patients. Thus, this study examined the interactive effects of the intensive control of all 3 conditions on the progression of renal function. MATERIALS AND METHODS: The study population was derived from eight hospitals in Taiwan from October 2008 to April 2015. Demographic characteristics were collected using structured questionnaires. Clinical variables were obtained from medical chart review. The renal progression was defined as a decline in the eGFR by more than 25% according to the baseline eGFR. RESULTS: Total of 1602 diabetes patients were included in the study analysis, the mean age was 63.03±10.98years, 55.56% were men. Compared to the simultaneous control of glycemic, blood pressure and lipid group, the poor control of all three diseases had the highest risk of renal progression, with an adjusted OR of 2.21 (95% CI, 1.26-3.86). Even if the patients with an intensive control of lipid, the result showed that the poor control of both glycemic and hypertension was associated with the increased risk of renal progression than the reference group. CONCLUSION: This study demonstrated that the simultaneous poor control of glycemic, blood pressure, and lipid had the highest risk of renal progression. Thus, patients with type 2 diabetes should not only control glycemic but also manage their blood pressure and lipid.
BACKGROUND AND AIM: Hyperglycemic, hypertension, and lipid abnormalities are risk factors for diabetic kidney disease However, no study has discussed the association of the simultaneous control of glycemic, blood pressure, and lipids with renal function among diabetespatients. Thus, this study examined the interactive effects of the intensive control of all 3 conditions on the progression of renal function. MATERIALS AND METHODS: The study population was derived from eight hospitals in Taiwan from October 2008 to April 2015. Demographic characteristics were collected using structured questionnaires. Clinical variables were obtained from medical chart review. The renal progression was defined as a decline in the eGFR by more than 25% according to the baseline eGFR. RESULTS: Total of 1602 diabetespatients were included in the study analysis, the mean age was 63.03±10.98years, 55.56% were men. Compared to the simultaneous control of glycemic, blood pressure and lipid group, the poor control of all three diseases had the highest risk of renal progression, with an adjusted OR of 2.21 (95% CI, 1.26-3.86). Even if the patients with an intensive control of lipid, the result showed that the poor control of both glycemic and hypertension was associated with the increased risk of renal progression than the reference group. CONCLUSION: This study demonstrated that the simultaneous poor control of glycemic, blood pressure, and lipid had the highest risk of renal progression. Thus, patients with type 2 diabetes should not only control glycemic but also manage their blood pressure and lipid.
Authors: Allison A Lewinski; Uptal D Patel; Clarissa J Diamantidis; Megan Oakes; Khaula Baloch; Matthew J Crowley; Jonathan Wilson; Jane Pendergast; Holly Biola; L Ebony Boulware; Hayden B Bosworth Journal: J Med Internet Res Date: 2019-04-09 Impact factor: 5.428