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Increased renal arterial resistance predicts the course of renal function in type 2 diabetes with microalbuminuria

Nosadini, Romano and Velussi, Mario and Brocco, Enrico and Abaterusso, Cataldo and Carraro, Andrea and Piarulli, Francesco and Morgia, Giuseppe and Satta, Andrea Ercole and Faedda, Rossana and Abhyankar, Avinash and Luthman, Holger and Tonolo, Giancarlo (2006) Increased renal arterial resistance predicts the course of renal function in type 2 diabetes with microalbuminuria. Diabetes, Vol. 55 (1), p. 234-239. ISSN 0012-1797. eISSN 1939-327X. Article.

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DOI: 10.2337/diabetes.55.01.06.db05-0881

Abstract

Type 2 diabetic patients often die because of end-stage renal failure, but no definitive reliable factor predicting long-term renal outcome has been identified. We tested whether a renal arterial resistance index (R/I) ≥80, using Doppler ultrasound technique, was predictive of worsening renal function. The primary end points of the study were 1) the course of glomerular filtration rate (GFR) and 2) the albumin excretion rate in 157 microalbuminuric, hypertensive, type 2 diabetic patients after a 7.8-year follow-up period (range 7.1–9.2). Kaplan-Meier curves for the primary end point (decrease of GFR ≥−3.0 ml/min per 1.73 m2 per year) was two to three times more frequently observed in patients with R/I ≥80. Four- to fivefold fewer patients showed a regression to normoalbuminuria during the follow-up period from baseline microalbuminuria in the cohort with R/I ≥80. Overt proteinuria did develop in 24% of patients with R/I ≥80 and in 5% of patients with R/I <80 (P < 0.01). In conclusion, intrarenal arterial resistance appears to play a nontrivial role in deteriorating renal function in type 2 diabetic patients. R/I is a noninvasive diagnostic procedure, which strongly predicts the outcome of renal function in type 2 diabetic patients, even when GFR patterns are still normal.

Item Type:Article
ID Code:10769
Status:Published
Refereed:Yes
Uncontrolled Keywords:Renal arterial resistance, renal function, type 2 diabetes, microalbuminuria
Subjects:Area 06 - Scienze mediche > MED/13 Endocrinologia
Area 06 - Scienze mediche > MED/14 Nefrologia
Area 06 - Scienze mediche > MED/24 Urologia
Divisions:001 Università di Sassari > 03 Istituti > Clinica medica generale e terapia medica
001 Università di Sassari > 03 Istituti > Oftalmologia, Otorinolaringoiatria e Urologia
Publisher:American Diabetes Association
ISSN:0012-1797
eISSN:1939-327X
Deposited On:06 Feb 2015 13:10

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