The Prevalence and Risk Factors of Diabetic Nephropathy in Taiwanese Type 2 Diabetes—a Hospital–based Study

Background: Diabetic nephropathy is the major cause of end-stage renal disease and is associated with cardiovascular morbidity and mortality. Recent data reported a high prevalence of diabetic nephropathy in Asian type 2 diabetic patients. The aims of this study were to determine the prevalence of diabetic nephropathy (microalbuminuria or macroalbuminuria) in type 2 diabetes and to identify the risk factors for nephropathy in this population. Method: A total of 1069 type 2 diabetic patients were recruited in this cross-sectional study and they were stratified according to urinary albumin excretion rate. The association between diabetic nephropathy and its traditional and nontraditional risk factors was analyzed. Results: The prevalence of normo-, microand macroalbuminuria was 60.3, 27.0 and 12.7%, respectively. Many factors differed between patients with and without diabetic nephropathy, including age, duration of diabetes, waist circumference, body mass index (BMI), serum creatinine, hemoglobin A1c (HbA1c), highdensity lipoprotein (HDL)-cholesterol, triglyceride, presence of retinopathy, insulin use and use of reninangiotensin system (RAS) blockades. Multivariate regression analysis revealed that only duration of diabetes (OR: 1.029, 95% CI: 1.001 – 1.057, P = 0.042); waist circumference (OR: 1.047, 95% CI: 1.016 – 1.078, P < 0.005); serum creatinine (OR: 1.821, 95% CI: 1.244 – 2.666, P < 0.005), HbA1c (OR: 1.276, 95% CI: 1.134 – 1.437, P < 0.005), triglyceride (OR: 1.002, 95% CI:1.000 – 1.004, P = 0.033); retinopathy (OR: 2.372, 95% CI:1.647 – 3.415, P < 0.005); and use of RAS blockades (OR: 0.514, 95% CI: 0.368 – 0.718, P < 0.005) were independent risk factors. Conclusions: The prevalence (40 %) of diabetic nephropathy in this study was not different from that in major Caucasian or European studies. The risk factors identified in the present study are similar to those reported in the literature. Implementing effective interventions to improve management of these risk factors may lower the risk of development of diabetic nephropathy. (Acta Nephrologica 2009; 23: 90-95)