Diabetes Care, Vol 21, Issue 7 1080-1085, Copyright © 1998 by American Diabetes Association

ARTICLES

High incidence of diabetic nephropathy in early-onset Japanese NIDDM patients. Risk analysis

H Yokoyama, M Okudaira, T Otani, C Watanabe, H Takaike, J Miuira, H Yamada, K Mutou, A Satou, Y Uchigata and Y Iwamoto
Diabetes Center, School of Medicine, Tokyo Women's Medical University, Japan.

OBJECTIVE: Because early-onset Japanese NIDDM patients (diagnosed before age 30 years) can develop diabetic end-stage renal failure (ESRF) in their thirties, this study was performed to elucidate the incidence and determinants for the development of diabetic nephropathy. RESEARCH DESIGN AND METHODS: The incidence of diabetic nephropathy and its relationship to baseline characteristics and long-term metabolic control were determined in 426 early-onset Japanese NIDDM patients who were followed for a mean of 6.8 years. RESULTS: Of these 426 patients, 41 developed diabetic nephropathy manifested by persistent proteinuria (incidence rate [95%CI]/1,000 person-years; 14.1 [10.4-19.1]). Among patients whose mean HbA1c (measured by a high-performance chromatography method that is standardized and comparable to the one used in the Diabetes Control and Complications Trial study) was around 7% or less, few developed nephropathy. The incidence of nephropathy increased with increasing mean HbA1c level in a dose-dependent manner (chi 2 trend = 49.9, P < 0.0001). Diastolic blood pressure and duration of diabetes at entry had significant predictive effects independent of metabolic control. CONCLUSIONS:The incidence rate of diabetic nephropathy in early-onset Japanese NIDDM patients is potentially high, similar to or higher than that in Pima Indian NIDDM or Caucasian IDDM patients of comparable age. Diabetic nephropathy in NIDDM patients aged in their thirties or forties is likely to be an early feature that leads to ESRF, and this would contribute to the marked increase in the number of new patients with diabetic ESRF in Japan. NIDDM is a serious disease if near-normal glycemia is not achieved.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. Teichert, T. Tuemmers, H. Achenbach, C. Preiss, R. Hermann, P. Ruus, and R. Preiss Pharmacokinetics of Alpha-Lipoic Acid in Subjects With Severe Kidney Damage and End-Stage Renal Disease J. Clin. Pharmacol., March 1, 2005; 45(3): 313 - 328. [Abstract] [Full Text] [PDF]

				K. Wakai, S. Nakai, K. Kikuchi, K. Iseki, N. Miwa, I. Masakane, A. Wada, T. Shinzato, Y. Nagura, and T. Akiba Trends in incidence of end-stage renal disease in Japan, 1983-2000: age-adjusted and age-specific rates by gender and cause Nephrol. Dial. Transplant., August 1, 2004; 19(8): 2044 - 2052. [Abstract] [Full Text] [PDF]

				G. Bruno, F. Merletti, A. Biggeri, G. Bargero, S. Ferrero, G. Pagano, and P. C. Perin Progression to Overt Nephropathy in Type 2 Diabetes: The Casale Monferrato Study Diabetes Care, July 1, 2003; 26(7): 2150 - 2155. [Abstract] [Full Text] [PDF]

				D. Devineni, Y. H. Walter, H. T. Smith, J. S. Lee, P. Prasad, and J. F. McLeod Pharmacokinetics of Nateglinide in Renally Impaired Diabetic Patients J. Clin. Pharmacol., February 1, 2003; 43(2): 163 - 170. [Abstract] [Full Text]

				M. C.Y. Ng, S.-C. Lee, G. T.C. Ko, J. K.Y. Li, W.-Y. So, Y. Hashim, A. H. Barnett, I. R. Mackay, J. A.J.H. Critchley, C. S. Cockram, et al. Familial Early-Onset Type 2 Diabetes in Chinese Patients: Obesity and genetics have more significant roles than autoimmunity Diabetes Care, April 1, 2001; 24(4): 663 - 671. [Abstract] [Full Text]

				D. T. Lackland, H. E. Bendall, C. Osmond, B. M. Egan, and D. J. P. Barker Low Birth Weights Contribute to the High Rates of Early-Onset Chronic Renal Failure in the Southeastern United States Arch Intern Med, May 22, 2000; 160(10): 1472 - 1476. [Abstract] [Full Text] [PDF]