Analysis on influencing factors of abnormal renal function in elderly patients with type 2 diabetes mellitus

To investigate the related influencing factors of abnormal renal function in elderly in patients with type 2 diabetes mellitus (T2DM) and their clinical significance.

The clinical data of elderly T2DM patients hospitalized in Beijing Luhe Hospital from January 2013 to June 2016 were retrospectively analyzed. According to their glomerular filtration rate (GFR) levels, these patients were divided into GFR≥90 mL/min/1.73 m2 group (group A), GFR =60-90 mL/min/1.73 m2 group (group B), and GFR <60 mL/min/1.73 m2 group (group C, i.e., abnormal renal function group). Clinical and laboratory indicators were compared among each group.

A total of 614 elderly T2DM patients were collected and divided into group A (N.=186), group B (N.=280) and group C (N.=148, 24.10%). Among them, patients clinically diagnosed with diabetic nephropathy (DN) accounted for 13.68%, and those complicated with high blood pressure (HBP) accounted for 61.40%. In Group C, DN accounted for only 29.73%. In elderly T2DM patients, HBP course, systolic blood pressure (SBP), diastolic blood pressure (DBP), 2h postprandial blood glucose (2hPBG), serum total cholesterol (TC) and blood uric acid (BUA) were independent influencing factors associated with abnormal renal function, among which HBP had a more significant impact on abnormal renal function. With the increase of blood pressure (BP) level, the extension in the course of DM, the increase in urinary albumin/creatinine (Alb/Cr) and the decrease in GFR, the incidence rate of abnormal renal function was increased.

HBP course, SBP, DBP, 2hPBG, TC and BUA are independent risk factors for abnormal renal function in elderly patients with T2DM. Well-controlled BP and blood glucose are protective factors, and a comprehensive treatment targeting to the above influencing factors has important clinical significance in preventing and delaying the occurrence and development of abnormal renal function.