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Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
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Improvement in glomerular filtration rate may decrease mortality among type-2 diabetics with chronic kidney disease

Bijin Thajudeen1, Pooja Budhiraja, Edward Meister

  • 1Department of Nephrology, Southern Arizona Veterans Affairs Health Care System; Department of Nephrology, University of Arizona College of Medicine, Tucson, AZ, USA.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|July 17, 2015
PubMed
Summary

In type-2 diabetes mellitus patients with chronic kidney disease (CKD) but no proteinuria, a significant number showed improved kidney function. However, mortality was higher in those with declining kidney function.

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Area of Science:

  • Nephrology
  • Endocrinology
  • Internal Medicine

Background:

  • Type-2 diabetes mellitus (T2DM) is a leading cause of chronic kidney disease (CKD).
  • Progression to CKD in T2DM patients without albuminuria is significant, yet factors influencing CKD progression, renal dysfunction, and mortality in this subgroup remain understudied.

Purpose of the Study:

  • To investigate the natural course of renal dysfunction, mortality, and other outcomes in male T2DM patients with established CKD but without proteinuria.

Main Methods:

  • Retrospective review of medical records for 121 male T2DM patients (age > 40) with CKD and no proteinuria.
  • Outcomes assessed included all-cause mortality, need for hemodialysis (HD), development of proteinuria, and trends in estimated glomerular filtration rate (eGFR).

Main Results:

  • All-cause mortality was 33%, with a mean age at death of 75.9 years.
  • Remarkably, 63% of patients experienced an improvement in eGFR during the follow-up period.
  • Mortality was significantly higher in patients with worsening eGFR compared to those with improving eGFR (61% vs. 39%, P=0.040).
  • 5.8% required hemodialysis, and 16.51% developed proteinuria, which was associated with a higher tendency for renal failure progression.

Conclusions:

  • A substantial proportion of type-2 diabetic patients with CKD and no proteinuria can experience improved kidney function over time.
  • Identifying and addressing potentially reversible causes of kidney damage is crucial for reducing mortality in this patient population.