State Analysis of 240 Patients With Diabetic Nephropathy in Community

Objective To observe the progress of diabetic nephropathy in type 2 diabetes mellitus(DM) patients who were treated by routine therapy.Methods 240 patients with diabetic nephropathy and type 2 diabetes mellitus were divided into normal albuminuria group,microalbuminuria group and clinical nephropathy group randomly.All patients were treated by routine therapy,included controlling blood glucose and blood pressure,diabetic diet,diabetes education and other symptomatic treatment.The following indexes were detected,such as urinary albumin excretion rate(UAER),urinary albumin/creatinine ratio(A/C),creatinine clearance(Ccr),glycosylated hemoglobin(HbA1C),mean arterial blood pressure(MABD).Results There were no significant difference among three groups for HbA1C and MABD before the trial(P0.05).The level of blood pressure and HbA1C decreased significantly after the trial than those before the trial(P0.05).These two indexes in clinical nephropathy group were higher than those in normal albuminuria group at the end of the trial(P0.05),but they were not significant between those in normal albuminuria group and those in microalbuminuria group,and between microalbuminuria group and clinical nephropathy group(P0.05).UAER and A/C in three groups after the trial were higher than those before the trial respectively.The decrease of Ccr and increase of Cr per year in clinical nephropathy group were highest among three groups at the end of the trial(P0.01).20% patients in normal albuminuria group,33.3 % in microalbuminuria group and 40% in clinical nephropathy group were deteriorative.The difference was significant between clinical nephropathy group and normal albuminuria group(P0.01),but no difference between other each two groups(P0.05).Conclusions The increasing of UAER and A/C ratio are always followed by the fast decrease of renal function in patients with diabetic nephropathy.This indicates that we must interfere in it as soon as possible and search for effective therapy to decrease urinary albumin excretion early.