Phenotyping normal kidney function in elderly patients with type 2 diabetes: a cross-sectional multicentre study

Carla Giordano, Ivano Franzetti, Olga Lamacchia, Alessandra Dei Cas, Fabrizio Querci, Gian Pio Sorice, Vera Frison, Nino Cristiano Chilelli, Gaetano Leto, Giovanni Grossi, Manfredi Rizzo, Edoardo Duratorre, Carmela Vinci, Carlo Mannina, Giuseppe Capobianco, Federica D’Angelo, Giuseppe Saglietti, Massimiliano Petrelli, Giuseppe Felace, Maurizio PoliAchiropita Pucci, Antonino Di Benedetto, Salvatore Piro, Salvatore Arena, Silvestre Cervone, Roberta Chianetta, Paola D’Angelo, Anna Solini, Lucia Frittitta, Paola Silvia Morpurgo, Carla Giordano, Patrizia Li Volsi, Ioannis Karamouzis, Ioannis Karamouzis, Bruno Fattor, Antonino Di Benedetto, Paola Silvia Morpurgo, Fadini, Natalino Simioni, Bruno Fattor, Roberto Anichini, Paola Silvia Morpurgo, Francesco Andreozzi, Gianluca Aimaretti, Frittitta, Ivana Zavaroni, Giuseppe Penno, Emanuela Orsi, Franco Cavalot, Susanna Morano, Antonino Di Benedetto, Enzo Bonora, Massimo Boemi, Giorgio Sesti, Angelo Avogaro, Annunziata Lapolla, Maria Laura Manca, Raffaella Buzzetti, Anna Solini, Solini, Riccardo Bonadonna, Massimo Cigolini, Antonio Carlo Bossi, Adriano Gatti, Agostino Consoli, Manfredi Rizzo, Giuliana Cazzetta, Gloria Formoso, Zatti, Eleonora Devangelio

Risultato della ricerca: Articlepeer review

2 Citazioni (Scopus)

Abstract

AimsType 2 diabetes (T2D) accelerates the decline in glomerular function; however, some individuals do not develop chronic kidney disease despite advanced age and long-lasting T2D. We aimed to phenotype patients with T2D aged 80years or older who presented with a fully preserved kidney function.MethodsFrom an Italian population of 281,217 T2D outpatients, we collected data on demographics, anthropometrics, diabetes duration, HbA1c, fasting plasma glucose, lipids, liver enzymes, estimated glomerular filtration rate (eGFR), albumin excretion rate (AER), chronic complications, and medication use. We primarily compared patients with a fully preserved kidney function (eGFR>90ml/min/1.73m(2) and AER<30mg/24h, or G1A1) with those with mild kidney impairment (eGFR 60-90ml/min/1.73m(2) and AER<30mg/24h, or G2A1).ResultsN=113,860 had available data for eGFR and AER, 21,648 of whom were aged80. G1A1 (n=278) and G2A1 (n=6647) patients represented 1.3 and 30.7% of aged T2D patients, respectively, with an average diabetes duration of 16years. Differences between the G1A1 and G2A1 groups were entered in a multiple logistic regression analysis with and without imputation of missing data. After adjustment and in both imputed and non-imputed datasets, younger age, lower BMI and lower triglycerides were associated with fully preserved versus mildly impaired kidney function. The comparison between G1A1 and G1A2/3 yielded different results.ConclusionsIn a rare population of patients with a fully preserved kidney function despite old age and long-lasting diabetes, lower BMI and triglycerides suggest that protection from lipotoxicity may preserve kidney function over time.
Lingua originaleEnglish
pagine (da-a)1121-1129
Numero di pagine9
RivistaActa Diabetologica
Volume55
Stato di pubblicazionePublished - 2018

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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