INCREASED FAMILIAL HISTORY OF ARTERIAL-HYPERTENSION, CORONARY HEART-DISEASE, AND RENAL-DISEASE IN BRAZILIAN TYPE-2 DIABETIC-PATIENTS WITH DIABETIC NEPHROPATHY

OBJECTIVE - To evaluate whether there is a familial association of art erial hypertension, coronary heart disease, renal disease, and stroke with diabetic nephropathy. RESEARCH DESIGN AND METHODS - There were 11 5 outpatients and 34 patients with end-stage renal disease treated by hemodialysis (61 men, age range 41-81 years) and having at least one s ibling with type 2 diabetes studied. The positive or negative history of siblings (n = 765) was assessed by a standard questionnaire. The ur inary albumin excretion rate (UAER) was measured by radioimmunoassay i n 24-h sterile urine (three samples). The subjects were grouped as nor moalbuminuric (UAER <20 mu g/min, n = 59), microalbuminuric (UAER 20-2 00 mu g/min, n = 35), macroalbuminuric (UAER >200 mu g/min, n = 21), a nd end-stage renal disease (n = 34). RESULTS - Patients with microalbu minuria, macroalbuminuria, or end-stage renal disease had an increased prevalence of sibling history of arterial hypertension (33.2, 37.3, a nd 33.8 vs. 23.4%, P < 0.001) and coronary heart disease (15.2, 17.0, and 19.4 vs. 10.2%, P = 0.044) compared with the normoalbuminuric grou p. The renal disease history was increased only in the siblings of pat ients with macroalbuminuria or end-stage renal disease (12.8 and 15.6 vs. 7.6 and 6.1%, P = 0.005). The presence of sibling arterial hyperte nsion strongly increases the prevalence of sibling renal and coronary heart disease independent of patient renal status. CONCLUSIONS - There is an association of diabetic nephropathy and sibling history of arte rial hypertension and renal and coronary heart disease in type 2 diabe tic patients. These associations are not independent, and arterial hyp ertension may be their main determining factor.