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Decrease in glomerular filtration rate in Japanese patients with type 2 diabetes is linked to atherosclerosis

H Taniwaki1, Y Nishizawa, T Kawagishi

  • 1Second Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan.

Diabetes Care
|November 5, 1998
PubMed
Summary

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Atherosclerosis impacts kidney function in type 2 diabetes patients. Measures of carotid artery and renal artery atherosclerosis were linked to reduced glomerular filtration rate (GFR) in early-stage diabetic nephropathy.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Diabetology

Background:

  • Type 2 diabetes is a leading cause of chronic kidney disease.
  • Diabetic nephropathy is characterized by albuminuria and a decline in glomerular filtration rate (GFR).
  • Atherosclerosis is a common comorbidity in diabetic patients and may influence kidney function.

Purpose of the Study:

  • To investigate the association between atherosclerosis and GFR in type 2 diabetes patients with normoalbuminuria or microalbuminuria.
  • To identify specific markers of atherosclerosis that correlate with GFR decline.

Main Methods:

  • Sixty-one Japanese type 2 diabetes patients (age 40-69) were studied.
  • Glomerular filtration rate (GFR) was measured using the 99mTc-diethylenetriamine pentaacetic acid renogram method.

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  • Atherosclerosis was assessed via carotid artery intimal-medial thickness (IMT), carotid distensibility, and renal interlobar artery resistance index (RI) using ultrasonography and Doppler sonography.

    • Main Results:

    • GFR did not differ between patients with and without microalbuminuria.
    • GFR showed significant negative correlations with age, carotid IMT, carotid stiffness beta, and renal artery RI.
    • Multiple regression analysis identified carotid IMT, carotid stiffness beta, and renal artery RI as independent factors associated with GFR.

    Conclusions:

    • Atherosclerosis, particularly carotid artery stiffness and renal artery resistance, is associated with reduced GFR in type 2 diabetes patients.
    • These findings suggest that atherosclerosis contributes to the decline in kidney function in the early stages of diabetic nephropathy.