Diabetie nephropathy in type 2 diabetic patients at Lampang Hospital
Article Sidebar
Main Article Content
Abstract
Diabetic nephropathy is the most common cause of chronic kidne dieseases, and is associated with increasd cardiovascular mortality. Intensive blood glucose control to achieve HbAle < 7% and blood pressur < 130/80 mm Hg mitigates the incidence of nephordpathy in type 2 diabetic patiens. This study was conducted on 2017 type 2 diabetic patients. The prevalence of miroalbuminuria and macroalbuminuria wer 28.31% and 7.49% respectively. Risk factors contributing to diabetie nephropathy were high blood pressure, blood glucose, and triglycerides, low HDL, cholesterol, advanced age, and long duration of diavetes. The prevanlence of retinopathy was hither in patients with nephorpaty (26.62% with microalbuminuria, and 43.71% with macroalbuminuria). ACEL and ARB were used in most of the patients for blook ressure contro, which 37.53% of the total patients had blood pressure <130/80 mmHg, and 45.76% hsd HbAlc < 7%. ASA was prescribed in 6.57% of the patients with microalbuminuria, and 68.87% with macroalbuminuria, Education doctors and health care providers of desirable metabolic parameters as recommended
by ADA will help in improving diabetic managment, preventing and delaying diabetic complication, and reducing mortality
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
References
Valdmadred CT< Klein R, MoSS SE, Klein BE. The risk of cardiovascular disease mortality associated with older-onset diabeted mellitus. Arch Intern Med 2000; 160: 1093-2000.
Zandbergen AA, Lambers SW, Sijbrands EJ, Bootsma AH. Birntensive women with type 2 diabetes and microalbuminuria art at high risk for macrovascular disease. Diabetes Care 2006: 29: 1851-55.
America Diabetes Association. Nephrophathy in diabetes (Position statement). Diabet care 2004, 27(suppl.1) : s79 - s83.
Adler AI, Stevens RJ, Manley SE, Biloes RW, Cull CAm Holana RR. Devevolment and progression of nephorpathy in type 2 diaheres; the United Kingdom Prospective Study (UKPDS 64). Kidney Int 2003; 63: 255-32.
Murussi M, B aglio P, Gross JT, Silveiro SP. Risk factors for microalbuminuria and macroalbuminuria in type 2 diabeted patients : a 9-year follow-up study. Diabetes Care 2002; 25 : 1101-03.
Gali MA, Houtaard P. Borch-Jonhsen K, Parving HH. Riskfactors for development of inciipient and overt diabetic nephropathy in patients eith non-insulin dependent diabetes mellitus: prospective, observational study, BMJ 1997; 314: 783-88.
Stration IM, Adler Al, Neil HA, Mathews DR, Manley SE et al. Association of glycemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective obervational study. BMJ 2000; 321: 405-12.
Fiorett P, Steffes MW, Sutherland DE, Goetz PF, Mauer M, Reversal of lesions of diabetic nephropathy afer panccreas transplantation.
N Engt J Med 1998; 339: 69-75.
Ravid M, Brosh D, Ravid - Ssfran D, Levy Z, Rachami R. Main risk factors for nephropathy in type 2 diabetes mellitus ane plasma
choesterol tevels, mean blood perssure and thperglycemin, Arch Intell Med 1998; 158: 998-1004.
Nelson RG, Knomler WC, Pettitt DJ, Hanson RL, Bennett PH. Incidents snd determinants of elevated urinary albumin excretion
ine Pima Indians with NIDDM. Diabetes Care 1995. 18: 182-87.
Leitao CB, Boza JC, Canani LH, Pinotti AF, Kramer CK, Gross JL. Masked hypertension, urinary alblumin excretion rate, and
echocardiographic [arameters in putatively mormotensive type 2 diabetic patients, Diabetes Care 2007; 30: 1255-60.
Leitao CB, Canani LH, Bolson PB, Molon MP, Pinotti AF, Gross jL. Urinary albumin excretion rate is associated with increased
ambulatory blood pressure in nomoalbuminuric type , diabetic patients, Diabetes Care 2005; 28: 1724-29.
Sawicki PT, Didjurgeit U, Muthlhauser l, Bender R, Heinemann L, Berger M. Smoking is associated with progression of diabetic
nephropathy. Diabetes Care 1994; 17: 126-31.
Hovind P, Rossing P, Tarnow L, Parving HH. Smoking and progresion of diabetic nephrpathy in type 1 diabetes. Diabetes Care
; 26: 911-16.
Stone ML, Lee JW, Craing ME, Verge CF, Chan AK, Donaghue KC, Natural history and risk factors for microalbumuria in adolescents
with type 1 diabetes : a longitedinal study. Doabeters Care 2006; 29: 2072-77.
Moliteh ME, Rupp D, Carmethon M. Higher levels of HDL cholcstrol are associated with a decreased likelihood of albuminuria in
patients with long standing type 1 diabetes. Diabeted. Diabetes Care 2006; 26:78-82.
UK Propective Diabetes Studey (UKPDS) Group, Intensive blood glucose control with suplphonyluresas or insulin compared with
conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS). Lancet 1998; 352:837-53.
Shichiri M, Kisthikawa H, Ohkubo Y, Wake N. Long - term resullts of the Kumamoto Study on optimal diabetic control in type 2
diabetic patients. Diabetes Care 2000; 23(suppl. 2): B21-B29.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, et al. The Seventh Report of the joint National Commitee oe Precention,
Detection, Evaluation, and treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289: 2560-72.
Sasso PC, Salvatore T, Nicola LD, Conte G, Carbonara O, et al. Cardiovascular risk factors and disease managment in type 2 diabetie
patients with diabetic nephropathy. Diabetes Care 2006; 29: 498-503.
Ltndholm LH, Ibsen H, Dahlof B, Deverneus RB, Beevers G, et al. Cardiovascular morbidity and mortality in patients with diabetes ih
the Losartan intevention For Endpoint reduction in hypertenion stydy (LIFE); a randomized trial against atenolol. Lancer 2002; 359:
-10.
Ravid M. Brosh D, Levi Z, Bar-Dayan Y, Ravid D, Rachmani R. Use of enalapril to attenuate deciline in renal function in normotensive,
mormoalbuminuric patients with type 2 diabetes mellitus: a randomized, controlled trial, Ann Intern Med 1998; 218: 982-88.
Heart Outcomes prevention Evaluation Study Investigators: Effects of ramipril on cardiovascular adn microvascular outcomes in
people with deabetes mellitus : results of the HOPE study and MICRO-HOPE substudy. Lancet 2000; 355:2563-59.
Isbens H, Mogensen CE, Olsen MH, Dahlor B, Wachtell L.et al. Does albuminuria predict cardiovascular outcomes on treament with
lasartan versus atenolol in patients with diabetes, hyperternsion, and left ventricular hypertrophy?. .Diabetes Care 2006; 29: 595-600.
Final report on the aspirin component of the ongoing Physicans' health Study Research Group, N Engl J med 1989; 321: 129-35.
Hayden M, pignone M, Phillips C, Mulrow C, Asprin for the primary prevention of cardiovascular events : a summary of the evidence for
the IS [revemtove Services Task Force. Ann Intern Med 2002l 136L 161-72.
US preventive Services Task Force. Aspirin for the primary prevention of cardiovascular events: necommendation and rationale. Ann Intern
Med 2002; 136-157-60.
Yokoyama H, Kawai K, Kobayashi M : ont behalf of the Japan Diabetes Climical Data Managment Study group. Microalbuminuria is common
in Japanese type 2 diabetic patients : A nationwide survey from the Japan Diabetes Clinical Data Managerment Study group (JDDM 10). Diabetes Care 2007; 30: 989-92.
Ngarmukos C, Bunnag P, Kosachunhanun N, Krittiyaong S, Leelawatana R, et al. Thailand Deiavetes Registry Project: Prevalence, characteristiecs and treatment of patients with diabetic nephropathy. J Med Assoc Thai 2006; 89(suppl 1): s37-42.
Gross JL, Canani LH, Axevedo Mj, Caramori ML, Silverio Sp, Zehmanovitz T. Diabetic nephropathy : Dignosis prevention, and treatment. Diabetes care 2005; 28:164-760
Tatti P, Pahor M, Byington RP, DiMauro P, Guarisco R, et al. Outcome reults of the Fosingpril Versus Amlodipine Cardiovascular Events
Randomized Trial (FACET) in patients with hypertension ans NIDDM. Diabetes Care 1998; 21: 597-603.
Pfeffer MA, Swberg K, Granger CB, Held P, McMurray JJ, et al. Effects of candesartan on mortality and morbidity in patients with chronic heart failure : the CHARM-Overall programme, Lancet 2003; 362: 759-66.
McAlister FA, Chen Z, Campbell N, Tu K, Hua MD. Antithypertensive medication prescribing in 27, 822 elderly Candians with diaberes over the past decade. Diabetes Care 2006; 29" 836-41.