RISK-FACTORS FOR PROGRESSION OF DIABETIC NEPHROPATHY

Fifty-four patients with noninsulin-dependent diabetes mellitus, who h ad established nephropathy, were examined to evaluate the risk factors for the progression of diabetic nephropathy. Time-averaged values of blood pressure, serum total cholesterol and fasting plasma glucose con centrations, and the degree of proteinuria during their follow-up peri od (4.2 +/- 0.5 years) were calculated. The correlation between these values and the slope of the regression line for the reciprocal of seru m creatinine concentration over time, as an index of the speed of the progression of nephropathy, was examined. Age (61 +/- 1 years), mean a rterial pressure (109 +/- 1 mm Hg), and the degree of the proteinureia (2.1 +/- 0.1 in dipstick test) were correlated with the slope. Effect s of hypercholesterolemia and smoking on the slope were also examined. Mean arterial pressure was correlated with the slope significantly in patients without hypercholesterolemia (p < 0.05) and there was a tend ency bewteen these two in smokers (p < 0.06), while was no correlation found in patients with hypercholesterolemia or in nonsmokers. In addi tion, the relation between the slope and mean arterial pressure was re latively stronger in smokers without hypercholesterolemia than in nons mokers with hypercholesterolemia. Our data suggest that blood pressure control as well as smoking avoidance may be important in preventing t he progression of noninsulin-dependent diabetic nephropathy.