PMID- 19452241
OWN - NLM
STAT- MEDLINE
DCOM- 20091207
LR  - 20211020
IS  - 1437-7799 (Electronic)
IS  - 1342-1751 (Linking)
VI  - 13
IP  - 5
DP  - 2009 Oct
TI  - Anemia and hypertension are risk factors for both renal prognosis and survival in 
      patients with diabetes mellitus.
PG  - 473-479
LID - 10.1007/s10157-009-0191-5 [doi]
AB  - BACKGROUND: Diabetic nephrosclerosis is the most common cause of renal failure in 
      the industrialized countries. At the same time, the mortality rate of patients 
      with diabetes mellitus is high. METHODS: To clarify the factors influencing the 
      prognosis and survival of patients with diabetic nephrosclerosis, we carried out 
      a retrospective follow-up study of 166 cases (age, 55.6 +/- 1.0 years; 
      male/female, 110/56) by simple and multifactorial analyses of clinical data 
      recorded at time of renal biopsy, including survival after diagnosis of diabetic 
      mellitus (months), body mass index (BMI) (kg/m(2)) [body weight/(body 
      height)(2)], age (years), mean blood pressure (mBP) (mmHg) [diastolic BP + 
      (systolic BP - diastolic BP)/3], serum levels of albumin (mg/dl), urea nitrogen 
      (BUN) (mg/dl), serum creatinine (s-Cr) (mg/dl), total cholesterol (mg/dl), 
      triglyceride (mg/dl), and fasting blood sugar (FBS) (mg/dl), hematocrit (%), 
      HbA1c (%), urinary protein secretion (g/day), insulin resistance, BP control 
      (good, <140/90 mmHg or poor, > or =140/90 mmHg) after biopsies, and 
      pathomorphological parameters at the biopsy. RESULTS: We found a significant 
      association between renal prognosis and several factors, e.g., hypoalbuminemia, 
      anemia, high levels of BUN and s-Cr, hypercholesteremia, hypertriglyceridemia at 
      biopsy, poor control of BP after biopsies, Kimmelstiel-Wilson nodule, and severe 
      glomerular and tubulointerstitial damages at the biopsy. In addition, 
      associations between survival and factors such as low value of BMI, elderly age 
      at the biopsy, and poor control of BP after biopsies were significant. By 
      multivariate analysis we also found a significant association of renal prognosis 
      with anemia, BUN, severe glomerular damage at the biopsy, and poor control of BP 
      after biopsies. At the same time, poor control of BP after biopsies had a 
      significant association with survival. On Kaplan-Meier analysis, anemia at biopsy 
      and hypertension after biopsies are risk factors for both renal prognosis and 
      survival in diabetes mellitus patients. CONCLUSIONS: Our data strongly suggest 
      that good control of BP after biopsies and anemia at the biopsy play pivotal 
      roles in the prognosis and survival of patients with diabetic glomerulosclerosis.
FAU - Sasatomi, Yoshie
AU  - Sasatomi Y
AD  - Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka 
      University School of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Fukuoka, 
      814-0180, Japan. sasatomi@fukuoka-u.ac.jp.
FAU - Kaneoka, Hidetoshi
AU  - Kaneoka H
AD  - Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka 
      University School of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Fukuoka, 
      814-0180, Japan.
FAU - Abe, Yasuhiro
AU  - Abe Y
AD  - Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka 
      University School of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Fukuoka, 
      814-0180, Japan.
FAU - Ishimura, Atunori
AU  - Ishimura A
AD  - Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka 
      University School of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Fukuoka, 
      814-0180, Japan.
FAU - Ogahara, Satoru
AU  - Ogahara S
AD  - Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka 
      University School of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Fukuoka, 
      814-0180, Japan.
FAU - Murata, Toshiaki
AU  - Murata T
AD  - Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka 
      University School of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Fukuoka, 
      814-0180, Japan.
FAU - Uesugi, Noriko
AU  - Uesugi N
AD  - Department of Pathology, Fukuoka University School of Medicine, 7-45-1, Nanakuma, 
      Jonan-ku, Fukuoka, Fukuoka, 814-0180, Japan.
FAU - Takebayashi, Shigeo
AU  - Takebayashi S
AD  - Department of Pathology, Fukuoka University School of Medicine, 7-45-1, Nanakuma, 
      Jonan-ku, Fukuoka, Fukuoka, 814-0180, Japan.
FAU - Iwasaki, Hiroshi
AU  - Iwasaki H
AD  - Department of Pathology, Fukuoka University School of Medicine, 7-45-1, Nanakuma, 
      Jonan-ku, Fukuoka, Fukuoka, 814-0180, Japan.
FAU - Saito, Takao
AU  - Saito T
AD  - Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka 
      University School of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Fukuoka, 
      814-0180, Japan.
LA  - eng
PT  - Journal Article
DEP - 20090519
PL  - Japan
TA  - Clin Exp Nephrol
JT  - Clinical and experimental nephrology
JID - 9709923
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anemia/*complications
MH  - Biopsy
MH  - Blood Pressure/physiology
MH  - Diabetes Mellitus/*physiopathology
MH  - *Diabetic Nephropathies/diagnosis/etiology
MH  - Female
MH  - Humans
MH  - Hypertension/*complications
MH  - Kaplan-Meier Estimate
MH  - Kidney/*pathology/*physiopathology/surgery
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Risk Factors
MH  - Young Adult
EDAT- 2009/05/20 09:00
MHDA- 2009/12/16 06:00
CRDT- 2009/05/20 09:00
PHST- 2007/06/11 00:00 [received]
PHST- 2009/04/09 00:00 [accepted]
PHST- 2009/05/20 09:00 [entrez]
PHST- 2009/05/20 09:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
AID - 10.1007/s10157-009-0191-5 [pii]
AID - 10.1007/s10157-009-0191-5 [doi]
PST - ppublish
SO  - Clin Exp Nephrol. 2009 Oct;13(5):473-479. doi: 10.1007/s10157-009-0191-5. Epub 
      2009 May 19.