RENAL INVOLVEMENT IN TYPE-1 (IDDM) DIABETES IN SPAIN

Diabetic nephropathy (DN) is a major complication of diabetes with a s ignificant repercussion in health care with few epidemiological data a vailable in Spain. The aim of this multicenter cross-sectional study w as to establish the prevalence of renal involvement in a large group o f patients with type 1 (insulin-dependent) diabetes and evaluate sever al risk factors related to its development. One thousand eight hundred twenty-two patients (921 males, mean age: 30.5 +/- 9.7 years, diabete s duration 14.1 +/- 9.2 years) from the Endocrinology Units of Is Span ish hospitals were included in this study. Urinary albumin excretion ( UAE), plasma creatinine, lipid profile, HbA(1c), and family history of hypertension and nephropathy, smoking, arterial blood pressure and BM I were evaluated. The prevalence of microalbuminuria, established neph ropathy (patients with macroalbuminuria and those with renal failure) and hypertension was 14.1, 8.5 and 11.3%, respectively. On logistic re gression analysis, using the presence or absence of established nephro pathy as variable, smoking (P = 0.0005), years of diabetes evolution ( P < 0.00005), diastolic blood pressure (P<0.00005), HbA(1c) (P<0.00005 ) and triglycerides (P=0.0008) were included in the model. When analyz ing patients with microalbuminuria vs those with normoalbuminuria the variables included were smoking (P = 0.005), diastolic blood pressure (P = 0.0026), years of diabetes evolution (P < 0.00005) and HbA(1c) (P < 0.00005). The prevalence of diabetic nephropathy DN in type 1 (insu lin-dependent) diabetes in Spain is similar to that observed in other European countries. The association between diabetic nephropathy DN an d hypertension, lipid disorders and metabolic control is confirmed and smoking appears to be an additional risk factor to be considered in d iabetic care. (C) 1997 Elsevier Science Ireland Ltd.