Abstract: TH-PO719

Non Albuminuric Chronic Kidney Disease (NA-CKD) Phenotype in Patients (Pts) with Type 2 Diabetes (DM2): Results from a Population Based Study

Session Information

Category: Diabetes

  • 502 Diabetes Mellitus and Obesity: Clinical

Authors

  • Bianchi, Stefano, ASL Toscana Nordovest, Livorno, Italy
  • Poderelli, Elisa, ASL Toscana Nordovest, Livorno, Italy
  • Bilanceri, Chiara, ASL Toscana Nordovest, Livorno, Italy
  • Samoni, Sara, ASL Toscana Nordovest, Livorno, Italy
  • D'Aurizio, Eva, ASL Toscana Nordovest, Livorno, Italy
  • Grillo, Andrea, ASL Toscana Nordovest, Livorno, Italy
  • Bigazzi, Roberto, ASL Toscana Nordovest, Livorno, Italy
Background

Albuminuria (A) is considered the first clinical sign of renal involvment and it is widely used as the most useful screening test for CKD in pts with DM2. However, in the last years increasing evidences have shown that a significant number of pts with DM2 has stage 3-5 CKD without significant A, a condition known as NA-CKD. The aim of this study was to determine the prevalence of NA-CKD in pts with DM2, living in the Province of Livorno, Italy.

Methods

Pts with DM2 living in the Province of Livorno, Italy are routinely screened for the presence of CKD, as a part of a three years project financed by the Italian Ministry of Health Care (Italian HC system RF-2011-02346990). We have screened 6,142 pts (2,898 F and 3,244 M, mean age 71.3±(SD)11.1 yrs), measuring the estimated glomerular filtration rate (eGFR, CKD-EPI) and A (Ualb,mg/Ucreat,g).

Results

3,071 pts (50%) presented CKD in different stage ( 222 Stage 1,13.6%; 856 Stage 2,13.9%;1,227 Stage 3a, 20%; 579 Stage 3b, 9.4%; 147 Stage 4, 2.4% and 40 Stage 5, 0.6%). 1,573 pts with stage 3-5 CKD and measured A were classified as non albuminuric (748, 47.5%, 399 M and 409 F, mean age 77.1±(SD) 8.8 yrs) or albuminuric (825, 52.5%, 460 M and 365 F, mean age 76.9±(SD)9.4 yrs). 677 albuminuric pts had A >30<300 (82%) while148 (18%) had A >300. The albuminuric CKD phenotype was more prevalent in M than in F.

Conclusion

In our study half of pts with DM2 and stage 3-5 CKD shows NA-CKD and most of albuminuric pts have A in microalbuminuric range.Our population is under active investigation (blood pressure and lipis control, duration and metabolic control of diabetes etc) to evaluate which clinical pathways could be involved in the development of different CKD phenotypes in DM2. We are also following up these patients to investigate the renal and cardiovascular outcomes of the different phenotypes.

Funding

  • Government Support - Non-U.S.