Endocrine Abstracts

Objective: To evaluate prevalence of chronic kidney disease (CKD) and risk factors for decline of renal function in elderly patients with type 2 diabetes (T2DM) after 6 years of follow-up.

Methods: A cohort of 208 elderly patients (65 years or older) with T2DM participated in an examination during 2005, a 6-years follow-up examination during 2011. An estimated glomerular filtration rate (eGFR) was calculated using the modification of diet in renal disease equation. CKD was defined as eGFR <60 ml/min per 1.73 m² and worsening nephropathy was defined as eGFR <45 ml/min per 1.73 m².

Results: Among the 208 elderly patients with T2DM, 95 patients (45.7%) had CKD at baseline. Obesity, longer diabetes duration, and usage of ACEI or ARB were independent factors related to the presence of CKD. Mean follow-up duration was 54.9 months. On multivariate Cox analysis, elderly patients with diabetes duration ≥10 years had a 2.85-fold increased risk for worsening nephropathy compared with those with diabetes duration <5 years (95% CI 1.29–6.30; P=0.010). Compared with HbA_1c <8.0%, HbA_1c ≥9.0% had a 2.82-fold increased risk for worsening nephropathy (95% CI 1.40–5.69; P=0.004). Elderly patients with obesity showed worse renal prognosis than those without obesity (HR 1.89; 95% CI 1.01–3.53; P=0.045).

Conclusions: Since CKD was commonly accompanied in elderly patients with T2DM, it is important to monitor and manage renal function in those patients, especially who had diabetes duration ≥10 years or HbA_1c ≥9.0% or obesity.