[Evaluation of diabetic nephropathy in older patients with diabetes mellitus type 2].

INTRODUCTION: Diabetes currently affects more than 170 million people world-wide, but the World Health Organization (WHO) expects that the number of patients will double within the next 20 years. Diabetic nephropathy (DN) is the leading cause of kidney disease in patients who need renal replacement therapy. It is defined by increased urinary albumin excretion in the absence of other renal diseases. The goal of the study is evaluation of DN in older patients with diabetes mellitus (DM) type 2.

PATIENTS AND METHODS: Prospective study has been used to analyze 182 patients of old age with DM type 2 according to the criteria of WHO. According to the concentration of albumin in urine the patients were divided in 2 groups: the patients who have confirmed type 2 DM with DN and patients who have confirmed type 2 DM without DN. The following parameters were determined and compared in both groups of patients: age, sex, duration of diabetes, concentration of glucose in blood, microalbuminuria, blood pressure, smoking, obesity, and family history with kidney disease. Albumin/ creatinine ratio was calculated and concentration of albumin in urine was tested by specified albumin straps.

RESULTS: The prevalence of type 2 DM in the health care center is 3.64% and prevalence of DN is 24.72%. Results show that duration of DM type 2 is significantly longer in patients with DN (p<0.0001) and concentration of albumin in urine is inreased (p<0.0001), and that significantly higher concentration of HbA1c (p=0.005) and increased creatinine in serum (p=0.04) is present when compared with patients without DN. This study did not find evidence of age, sex, blood pressure, smoking, obesity and family history with kidney disease as risk factors in genesis of DN.

CONCLUSION: Duration of DM type 2, increased concentration of glycosyllated HbA1c, and increased creatinine in blood are the risk factors in genesis of DN in older patients with DM type 2.