Predictive Factors for Decline in Renal Function in Elderly Patients with Type 2 Diabetes from 20-year Retrospective Longitudinal Study

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  • 20年間の経過から得られた高齢2型糖尿病患者の腎機能予測因子
  • 20ネンカン ノ ケイカ カラ エラレタ コウレイ 2ガタ トウニョウビョウ カンジャ ノ ジンキノウ ヨソク インシ

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Objective: The aim of this study was to analyze factors associated with decline in renal function in elderly patients with type 2 diabetes.<br>Methods: Averages of body weights, body mass indexes (BMI), blood pressures, and laboratory test results between 1995 and 1999 were used as explanatory variables. We calculated average estimated glomerular filtration rates (eGFRs) for 1995-1999 and 2010-2014, and regarded the difference between the two as decline in renal function. We enrolled patients who met the following criteria: (1) patient who visited our hospital more than three times a year from January 1995 to January 2014, (2) who was diagnosed as having type 2 diabetes before 1995 and whose average HbA1c was higher than 6.5% between 1995 and 1999, (3) who was born before 1950, and (4) whose average eGFR for 1995-1999 was higher than 70 mL/min/1.73m2. We used Spearman’s rank correlation coefficients to investigate relationships between the decline in eGFR and the averages of parameters between 1995 and 1999, and conducted multiple linear regression analysis using the decline in eGFR as the objective variable.<br>Results: Based on correlation analysis, history of cardiovascular diseases, fatty liver, BMI, systolic blood pressure, blood glucose, gammma-glutamyltransferase (GGT), uric acid, high-density lipoprotein cholesterol, and urine albumin were all strongly correlated with decline in eGFR. Multiple linear regression showed that GGT and urine albumin were significantly correlated with the decline in eGFR.<br>Conclusion: In elderly patients with type 2 diabetes, higher urine albumin and higher GGT were associated with decline in eGFR.

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