The renal function abnormalities in type 2 diabetic patients with microalbuminuria or clinical proteinuria and the risk factor.

Objective To explore the renal function abnormalities in type 2 diabetic patients with microalbuminuria or clinical proteinuria and main risk factor. Method Type 2 diabetic patients were enrolled to this study, 82 patients were divided into three groups based on the urinary albumin excretion rate (UAER): normo-albuminuria group(UAER30mg/day), micro-albuminuria group(30mgUAER300mg/day),and clinical proteinuria group(UAER300mg/day).18 health adults were treated as controls. The body height and weight, blood pressure, fasting plasma glucose, serum creatinine, creatinine clearance, total cholesterol and triglyceride, plasma HbAlc and UAER were measured and statistic analysis were performed.Result Serum creatinine levels of patients elevated, and the creatinine clearance decreased markedly when clinical proteinuria appeared, there was significant difference when compared to controls and normoalbuminuria patients (P0.01 and P0.05 respectively). Correlation analysis indicated that there were significant negative correlations between creatinine clearance and body mass index(BMI), systolic blood pressure, serum creatinine levels, duration of diabetes and UAER. Multiple factors step-wise regression analysis indicated: as the decline of creatinine clearance, in microalbuminuria group, only serum creatinine level was the independent risk factor;in clinical proteinuria group, both serum creatinine level and BMI were independent risk factors (P=0.001 and P=0.03 respectively). Conclusion The creatinine clearance decreases when albuminuria appeared in type 2 diabetic patients. The decline of creatinine clearance in microalbuminuria patients may be due to a multi-factor influence such as elevation of systolic blood pressure and BMI, while in clinical proetinuria patients, the elevation of BMI is the main risk factor.