Assessment of cardiovascular risk in patients with type 2 diabetes and albuminuric diabetic kidney disease phenotype

Abstract

Introduction. The aim of this study is analysis of cardiovascular risk in non-albuminuric and albuminuric patients with type 2 diabetes and diabetic kidney disease. Material and Methods. The study included 136 patients with type 2 diabetes and chronic kidney disease (estimated glomerular filtration rate <90 ml/ min/1.73 m2). Patients were divided into two groups: Group A (patients without albuminuria) and Group B (patients with albuminuria). The cardiovascular risk was assessed through a retrospective analysis of data from electronic medical records. Results. We found statistically significantly more patients with stage 3a (Group A: 10% vs. Group B: 54%) and stage 3b (Group A: 7% vs. Group B: 13%; p<0.05) chronic kidney disease in the albuminuric group. These patients also had a longer duration of diabetes (Group A: 13.43?9.56 vs. Group B: 17.14?9.17 years; p<0.05), a higher frequency of male subjects (Group A: 44% vs. Group B: 63.9%; p<0.05) and a higher prevalence of smokers. The presence of hypertension was significantly more frequent in Group B (Group A: 89% vs. Group B: 97.2%; p<0.05). There was no significant difference between the groups in terms of age and metabolic control. However, coronary heart disease (Group A: 36% vs. Group B: 55.6%; p<0.05), peripheral artery disease (Group A: 16% vs. Group B: 22.2%; p<0.05), and stroke (Group A: 5% vs. Group B: 22.2%; p<0.05) were significantly more common in patients with type 2 diabetes and albuminuria. Conclusion. The albuminuric phenotype of diabetic kidney disease is associated with greater kidney function impairment, a longer duration of diabetes, and a higher prevalence in men. The presence of albuminuria significantly increases cardiovascular risk in people with type 2 diabetes and chronic kidney disease. Using renoprotective antihyperglycemic agents is essential in this group of patients, as they have an increased mortality risk.