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The role of glycemia and blood pressure control on the rate of decline in glomerular filtration rate in Vietnamese type 2 diabetes patients

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Abstract

The rate of decline in glomerular filtration rate (∆↓GFR), commonly used to evaluate the progression of chronic kidney disease (CKD), varies considerably among type 2 diabetes subjects. The determinants of the variability especially hyperglycemia and hypertension are not consistent. We present a retrospective cohort study [450 out of 536 patients with type 2 diabetes who did not have renal insufficiency at baseline (estimated GFR ≥ 60 ml/min/1.73 m2)]. We examined factors affecting progression of ∆↓GFR as an endpoint using linear regression analysis. The mean ∆↓GFR was 2.3 (SD 2.9) mL/min/1.73 m2/year. Univariate analysis showed that this was associated with mean HbA1c (P = 0.004), mean systolic blood pressure (BP) (P < 0.001), and mean pulse pressure (P < 0.001). Hazard ratio (HR) of the appearance of renal insufficiency was significantly higher in the group with mean systolic BP ≥ 130 mmHg (HR = 3.0, P < 0.001) and mean pulse pressure ≥ 50 mmHg (HR = 3.7, P < 0.001). In subjects with type 2 diabetes, glycemia and BP control play an important role on slowing the rate of decline in kidney function. Higher systolic BP and pulse pressure, but not diastolic BP, are significantly associated with increased ∆↓GFR.

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Acknowledgments

We are grateful to Dr.Tran The Trung- University of Medicine and Pharmacy, Hochiminh- for his excellent help in data analysis.

Conflicts of interest

There is no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Endocrinology, University of Medicine and Pharmacy, Hochiminh, Vietnam

    Oanh Hoang Do & Khue Thy Nguyen

  2. 6/45 Station Road, Indooroopilly, QLD, 4068, Australia

    Oanh Hoang Do

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  1. Oanh Hoang Do
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  2. Khue Thy Nguyen
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Correspondence to Oanh Hoang Do.

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Do, O.H., Nguyen, K.T. The role of glycemia and blood pressure control on the rate of decline in glomerular filtration rate in Vietnamese type 2 diabetes patients. Int J Diabetes Dev Ctries 33, 96–100 (2013). https://doi.org/10.1007/s13410-013-0112-8

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  • DOI: https://doi.org/10.1007/s13410-013-0112-8

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