PREVALENCE OF CANDIDATES FOR PREVENTION OF DIABETIC NEPHROPATHY IN A COHORT OF ADULT INSULIN-DEPENDENT DIABETIC-PATIENTS

Background and Aim: The prevalence of microalbuminuria and its determi nants are poor ly known in the Italian population of insulin-dependent diabetic patients, and candidates for prevention of diabetic nephropa thy should be recognized in clinical practice. Methods and Results: Bl ood pressure, albumin excretion rate (three times over 6 months), HbA( 1c) (median of at least 4 values in the last year), plasma lipids and retinopathy were measured on all adult insulin-dependent diabetic out- patients (n=589) without macroalbuminuria, attending 13 centers. Poor glycaemic control (HbA(1c) > 4 SD above the mean of normal) was found in 68% of the patients and hypertension (less than or equal to 140 and /or 90 mmHg) in 19.2%, with similar sex distribution. The proportion o f patients with poor glycaemic control (84 vs 65%, p<0.002) and hypert ension (greater than or equal to 140 and/or 90 mm Hg: 45 vs 15%, p<0.0 001) was higher in the microalbuminuric group, but was relevant also i n the normoalbuminuric group, The prevalence of hypertension increased twice in the microalbuminuric group and four times in the normoalbumi nuric group when previous World Health Organization (WHO) (greater tha n or equal to 160 and/or 95 mmHg) and JNC-V (greater than or equal to 140 and/or 90 mmHg) criteria were compared, The prevalence of microalb uminuria (8.5%), hypertension (15.3% with JNC-V criteria) and poor gly caemic control (64%) was Mot negligible even in patients with a diabet es duration of 2-5 years. Conclusions: The proportion of adult insulin -dependent diabetic patients who may be candidates for prevention of d iabetic nephropathy is relevant in normal clinical practice. (C) 1998, Medikal Press.