The Effects of Type II Diabetes Mellitus on Renal Parameters with Hypertensive Patients: Comparative Study

Yıl 2017, , 88 - 92, 20.06.2017

Hamza Aslanhan Ahmet Yılmaz

https://doi.org/10.21763/tjfmpc.317779

Öz

Objective:
Hypertension and diabetes mellitus are two groups of diseases common in society
and increase the morbidity and mortality by affecting many systems. The aim of
this study is to research renal functions of patients diagnosed with
hypertension and type 2 diabetes mellitus in addition to hypertension and to
evaluate by comparing the effects of these diseases on kidney.  Method: The 85 hypertension patients and
85 diabetes mellitus and hypertension patients, totally 170 patients, between
35-70 ages involved in this study by retrospectively screening the archive
files of internal medicine and diabetes outpatient clinics. Clinical findings
and demographic features have been noted by screening the patient files in both
groups. Results: The rate of albuminuria was significantly higher in
diabetes mellitus and hypertension group (30.6%) than hypertension group
(16.5%) (p=0.047). In terms of the prevalence of cases whose glomerular
filtration rate <60mL/min/1.73m2, there was no significant difference
between HT group (2.4%) and diabetes mellitus and hypertension group (5.9%),
(p=0.44).  Conclusion: Type 2
diabetes mellitus; increases albuminuria in patients with hypertension. This
situation may be predictor of rapid progression to renal failure.

Amaç: Diabetes
mellitus ve hipertansiyon, toplumda yaygın olarak görülen iki hastalık grubu
olup bir çok sistemi etkileyerek, mortalite ve morbiditeyi arttırmaktadır. Bu
çalışmanın amacı, hipertansiyon ile hipertansiyona ek olarak Tip 2 diabetes mellitus
tanısı olan hastaların, renal fonksiyonlarının incelenmesi ve bu hastalıkların
böbrek üzerindeki etkilerinin karşılaştırılarak değerlendirilmesidir. Yöntem:
Çalışmaya, İstanbul Eğitim Araştırma Hastanesi dahiliye ve diyabet
polikliniklerinde ayaktan takip edilen, 35-70 yaşları arasında 85
hipertansiyon, 85 Tip 2 diabetes mellitus ve hipertansiyon tanılı, toplam 170
adet hasta arşiv dosyaları retrospektif olarak taranarak dahil edildi. Her iki
gruptan, klinik bulgular ve demografik özellikler taranarak kayıt edildi. Bulgular:
Tip 2 diabetes mellitus ve hipertansiyon grubunda, albüminüri oranı (%30,6),
hipertansiyon grubundan (%16,5) anlamlı olarak daha yüksekti (p=0,047).
Glomerüler filtrasyon hızı <60 mL/dk/1,73m² olanların oranı
açısından hipertansiyon grubu ile (% 2,4) Tip 2 diabetes mellitus ve
hipertansiyon grubu (%5,9) arasında anlamlı farklılık yoktu (p=0,44). Sonuç:
Tip 2 diabetes mellitus; hipertansiyon hastalarında albüminüriyi
arttırmaktadır. Bu durum, böbrek yetmezliğine hızlı gidişin bir görüntüsü
olabilir.

Anahtar Kelimeler

Hypertension, Type 2 diabetes mellitus, Kidney disease

Kaynakça

• 1. Kotseva K, Wood D, De Backer G, De Bacquer D, Pyörälä K, Keil U, et al. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. The Lancet 2009;373(9667):929-40.
• 2. Sengul S, Akpolat T, Erdem Y, Derici U, Arici M, Sindel S, et al. Changes in hypertension prevalence, awareness, treatment, and control rates in Turkey from 2003 to 2012. Journal of hypertension 2016;34(6):1208.
• 3. Yenigün M, Altuntaş Y. Her yönüyle diabetes mellitus. Nobel Tıp 2001;(2):219.
• 4. Control CfD, Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention 2011;201(1).
• 5. Nan H, Dong Y, Gao W, Tuomilehto J, Qiao Q. Diabetes associated with a low serum uric acid level in a general Chinese population. Diabetes research and clinical practice 2007;76(1):68-74.
• 6. Büyükdevrim A, Büyükbeşe M, Davutoğlu MT. Diabetik Nefropati. Turgut Yayıncılık AŞ; 2005. p.8-11.
• 7. Klausen K, Parving HH, Scharling H, Jensen J. The association between metabolic syndrome, microalbuminuria and impaired renal function in the general population: impact on cardiovascular disease and mortality. Journal of İnternal Medicine 2007;262(4):470-8.
• 8. Yılmaz A, Kılınç F, Usman MG, Sucaklı MH, Tanrıverdi HM, Aslanhan H, et al. The prevalence of diabetes mellitus, dysglycaemia and factors that affect them in public employees of Kahramanmaras. Turkish Journal of Family Medicine & Primary Care 2015;9(3):99-103.
• 9. Satman İ, Yılmaz C. Glisemik bozukluklarda tanı sınıflama ve tedavi. Türkiye Endokrinoloji ve Metabolizma Derneği, Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlemi Kılavuzu. Müka Yayıncılık. 2008; 3:11-3.
• 10. Aydınbelge B, Kılınç A, Diri B, Duranay M, Saydam G, Yücel D. Gerçek kreatinin ölçümü için geliştirilen kreatinin ölçüm yöntemlerinin karşılaştırılması. Turk J Biochem 2011;36(4):356-61.
• 11. Kocabaş RN, Başol G. Proteinüri ve laboratuvar değerlendirmesi. Türk Klinik Biyokimya Derg 2006;4(3):133-45.
• 12. Parving HH, Chaturvedi N, Viberti G, Mogensen CE. Does microalbuminuria predict diabetic nephropathy? Diabetes Care 2002;25(2):406-7.
• 13. Michels WM, Grootendorst DC, Verduijn M, Elliott EG, Dekker FW, Krediet RT. Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clinical Journal of The American Society of Nephrology 2010;5(6):1003-9.
• 14. Lee GS. Retarding the progression of diabetic nephropathy in type 2 diabetes mellitus: focus on hypertension and proteinuria. Annals of The Academy of Medicine, Singapore 2005;34(1):24-30.
• 15. Barçın C. What has changed with the new European Society of Cardiology/European Society of Hypertension guideline? Archives of The Turkish Society of Cardiology 2014;42(1):1-6.
• 16. Tokgözoğlu L, Kayıkçıoğlu M, Altay S, Aydoğdu S, Barçın C, Bostan C, et al. EUROASPIRE-IV: Avrupa Kardiyoloji Derneği’nin koroner arter hastalarında yaşam tarzı, risk faktörleri ve tedavi yaklaşımı üzerine çalışması: Türkiye verileri. Turk Kardiyol Dern Ars 2017;45(2).
• 17. Cea-Calvo L, Conthe P, Gomez-Fernandez P, de Alvaro F, Fernandez-Perez C, investigators R. Target organ damage and cardiovascular complications in patients with hypertension and type 2 diabetes in Spain: a cross-sectional study. Cardiovascular Diabetology 2006; 5:23.
• 18. Redon J, Morales-Olivas F, Galgo A, Brito MA, Mediavilla J, Marin R, et al. Urinary albumin excretion and glomerular filtration rate across the spectrum of glucose abnormalities in essential hypertension. Journal of the American Society of Nephrology 2006;17(12 Suppl 3):236-45.
• 19. Kozan Ö, Ozcan E, Sancaktar O, Kabakcı G. The prevalence of microalbuminuria and relevant cardiovascular risk factors in Turkish hypertensive patients. Turk Kardiyol Dern Ars 2011;39(8):635-45.
• 20. Col M, Ocaktan E, Ozdemir O, Yalcin A, Tuncbilek A. Microalbuminuria: prevalence in hypertensives and diabetics. Acta medica Austriaca 2004;31(1):23-9.
• 21. Rius F, Pizarro E, Castells I, Salinas I, Sanmartí A, Romero R. Renal function changes in hypertensive patients with non-insulin-dependent diabetes mellitus. Kidney International Supplement 1996(55).
• 22. Stekiel TA, S JC, Bosnjak ZJ, Kampine JP, Roman RJ, Stekiel WJ. Reversal of minimum alveolar concentrations of volatile anesthetics by chromosomal substitution. Anesthesiology. 2004;101(3):796-8.
• 23. Redon J, Morales-Olivas F, Galgo A, Brito MÁ, Mediavilla J, Marín R, et al. Urinary albumin excretion and glomerular filtration rate across the spectrum of glucose abnormalities in essential hypertension. Journal of the American Society of Nephrology 2006;17(12 suppl 3):236-45.