Cardiovascular Risk Factors and Disease Management in Type 2 Diabetic Patients With Diabetic Nephropathy
- Ferdinando C. Sasso, MD, PHD1,
- Luca De Nicola, MD2,
- Ornella Carbonara, MD1,
- Rodolfo Nasti, MD1,
- Roberto Minutolo, MD2,
- Teresa Salvatore, MD1,
- Giuseppe Conte, MD2,
- Roberto Torella, MD1 and
- for the NID-2 (Nephropathy in Diabetes-Type 2) Study Group*
- 1Department of Clinical and Experimental Medicine “Magrassi-Lanzara,” Excellence Centre for Cardiovascular Disease, Second University of Naples, Naples, Italy
- 2Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy
- Address correspondence and reprint requests to Ferdinando Carlo Sasso, MD, PhD, Unit of Internal Medicine, Second University of Naples, Via F. Petrarca, 64, I-80122, Naples, Italy. E-mail: ferdinando.sasso{at}unina2.it
Abstract
OBJECTIVE—The purpose of this study was to assess the prevalence of cardiorenal risk factors, their management in a routine clinical setting, and the actual achievement of international guideline targets in a large cohort of type 2 diabetic patients with diabetic nephropathy.
RESEARCH DESIGN AND METHODS—A multicentric cross-sectional study was performed in the Campania region in Italy to evaluate cardiorenal risk factors and their management in light of international guidelines. Overall, 28,550 diabetic patients were screened in the 21 participating centers; 847 (348 male and 449 female) patients with type 2 diabetes and a clinical diagnosis of diabetic nephropathy were recruited.
RESULTS—Of these subjects, 749 had microalbuminuria and 98 had macroalbuminuria. Targets for blood pressure, HbA1c, LDL cholesterol, HDL cholesterol, and triglycerides were reached in, respectively, 17.5, 32.3, 30.7, 47, and 55.2% of the patients. Chronic renal failure (glomerular filtration rate <60 ml/min) was revealed in 41% and anemia in 23.8% of the patients.
CONCLUSIONS—This is the first study to investigate a large cohort of type 2 diabetic patients with early and moderate diabetic nephropathy strictu sensu. Notably, impaired renal function can be often diagnosed in these patients even in the presence of microalbuminuria. Thus, clinical diagnosis of diabetic nephopathy allows us to identify a group of patients at very high cardiorenal risk, for whom care is really difficult. We suggest that a correct diagnosis of diabetic nephropathy should always be made and that sodium intake and anemia should be routinely evaluated in these patients.
Footnotes
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↵* A complete list of NID-2 Study Group members can be found in the appendix.
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted November 20, 2005.
- Received September 21, 2005.
- DIABETES CARE
