Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

PROGRESSION OF KIDNEY FUNCTION IN TYPE 2 DIABETIC PATIENTS: A 10-YEAR COHORT STUDY

Author

Siow Foon Tan 1 , Yook Chin Chia 1 , Chinna Karuthan 2

Institution

1. Department of Primary Care Medicine, University of Malaya, Malaysia
2. Julius Center, University of Malaya, Malaysia

Abstract

Objectives: DM is associated with rapid decline of kidney function. This study examines it’s progression and associated factors over 10 years.

Methods: This is a retrospective study of type 2 diabetic patients (T2DM) attending a primary care clinic. Estimated glomerular filtration rate (eGFR) using the MDRD formula was used to measure the progression. Factors associated with progression were examined by multivariate analysis.

Results: 510 medical records were reviewed. Mean (SD) age of patients was 57.7±9 and 65.3% were females, 40.6% Indian, 34.7% Chinese, 23.3% Malays. Mean duration of diabetes was 7.7±6.7years. Baseline blood pressure (BP) was 139.5/83.6mmHg and HbA1c 8.5%. The mean decline rate of eGFR was 0.84 ml/min/year (from74.9±17.8 ml/min/1.73m2 to 66.5±25.4 ml/min/1.73m2). Decline rate of eGFR of more than 1ml/min/year was observed in 249(49%). 0.4% developed ESRF and were dialyzed. Proteinuria, age, Malay race were significantly associated with increased rate of decline in eGFR.

Conclusion: The decline of eGFR in this cohort was 0.84ml/min/year. The expected greater deterioration in renal function was not seen. This could in part be explained by improvement in BP, glycaemia and reduction of proteinuria with the use of ACE-inhibitors/ARB. Aggressive treatment is mandatory to reduce the deterioration of kidney function.