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INTRODUÇÃO: A nefropatia diabética é a principal causa de doença renal crónica no
mundo, associando-se principalmente à diabetes mellitus tipo 2. Existem diversos
fatores que estimulam a progressão desta para doença renal crónica estadio 5. Este
estudo tem como objetivo verificar o impacto dos fatores de risco na progressão da
doença renal diabética para o estadio 5 de doença renal crónica, nos doentes com
diabetes mellitus tipo 2 e nefropatia diabética seguidos nas consultas de nefrologia no
Centro Hospitalar e Universitário da Cova da Beira.
MÉTODOS: Estudo observacional e analítico de coortes retrospetivas. Analisaram-se os
processos clínicos a partir de registos disponíveis no SClinic dos doentes seguidos em
consulta de nefrologia no Centro Hospitalar e Universitário da Cova da Beira, com
doença renal crónica estadio 3 ou superior por nefropatia diabética, num período
compreendido entre janeiro de 2015 e novembro de 2019. Os dados recolhidos foram
referentes às variáveis idade, género, índice de massa corporal, tensão arterial sistólica e
diastólica, hemoglobina, HbA1c, concentração de ácido úrico plasmático, albuminúria e
realização de nefroproteção. A análise estatística foi realizada com recurso ao software
estatístico SPSS.
RESULTADOS: Foram analisados os processos clínicos de 71 doentes, dos quais 37 eram
do género masculino e 34 do género feminino, sendo que a média da idade da amostra
foi 77,5?8,4 anos. Verificou-se que os doentes com uma média de hemoglobina glicada
>7% apresentaram uma maior deterioração da taxa de filtração glomerular. A realização
de nefroproteção esteve associada a um menor declínio da taxa de filtração glomerular.
A média do IMC ?30 kg/m2
, valores médios de tensão arterial sistólica?120mmHg e/ou
tensão arterial diastólica ?80mmHg, albuminúria média ?30mg/24h e a média de ácido
úrico >7mg/dL não tiverem significância estatística (valor P?0.05).
CONCLUSÕES: Hemoglobina glicada>7% associa-se a um declínio maior da taxa de
filtração glomerular, pelo que favorece a progressão da nefropatia diabética. A realização
de nefroproteção com fármacos inibidores do SRAA atrasam a progressão da doença
renal diabética.
INTRODUCTION: Diabetic nephropathy is the leading cause of chronic kidney disease in the world, mostly associated with type 2 diabetes mellitus. There are several factors that stimulate its progression to stage 5 chronic renal disease. This study aims to verify the impact of risk factors on the progression of diabetic kidney disease to end-stage renal disease in patients with type 2 diabetes mellitus and diabetic nephropathy followed in the nephrology consultation at the CHUCB. METHODS: Observational and analytical study of retrospective cohorts. Clinical files were analyzed from SClinic records of patients from the nephrology consultation at the Cova da Beira Hospital and University Center, with chronic kidney disease at stage 3 or greater due to nephropathy, in a period between January 2015 and November 2019. Collected data were related to the variables age, gender, body mass index, systolic and diastolic blood pressure, glycated hemoglobin, hemoglobin, plasma uric acid, albuminuria, nephroprotection therapy. Statistical analysis was performed using SPSS statistic software. RESULTS: The clinical files of 71 patients were analyzed, of which 37 were male and 34 fem ale, with a mean age of 77,5 ? 8.4 years. Patients with an average glycated hemoglobin >7% were found to have a greater deterioration in glomerular filtration rate. Nephroprotection was associated with a lower decline in glomerular filtration rate. BMI ?30 kg/m2 , mean values of systolic blood pressure ?120 mmHg or diastolic blood pressure ?80 mmHg, average albumin ?30 mg/24h and mean uric acid >7 mg/dL weren’t statistically significant (P?0.05 value). CONCLUSIONS: An average glycated hemoglobin greater than 7% was associated with a greater decline in glomerular filtration rate, which favored the progress of diabetic nephropathy. Nephroprotection with inhibitors of RAAS delays the progression of diabetic kidney disease.
INTRODUCTION: Diabetic nephropathy is the leading cause of chronic kidney disease in the world, mostly associated with type 2 diabetes mellitus. There are several factors that stimulate its progression to stage 5 chronic renal disease. This study aims to verify the impact of risk factors on the progression of diabetic kidney disease to end-stage renal disease in patients with type 2 diabetes mellitus and diabetic nephropathy followed in the nephrology consultation at the CHUCB. METHODS: Observational and analytical study of retrospective cohorts. Clinical files were analyzed from SClinic records of patients from the nephrology consultation at the Cova da Beira Hospital and University Center, with chronic kidney disease at stage 3 or greater due to nephropathy, in a period between January 2015 and November 2019. Collected data were related to the variables age, gender, body mass index, systolic and diastolic blood pressure, glycated hemoglobin, hemoglobin, plasma uric acid, albuminuria, nephroprotection therapy. Statistical analysis was performed using SPSS statistic software. RESULTS: The clinical files of 71 patients were analyzed, of which 37 were male and 34 fem ale, with a mean age of 77,5 ? 8.4 years. Patients with an average glycated hemoglobin >7% were found to have a greater deterioration in glomerular filtration rate. Nephroprotection was associated with a lower decline in glomerular filtration rate. BMI ?30 kg/m2 , mean values of systolic blood pressure ?120 mmHg or diastolic blood pressure ?80 mmHg, average albumin ?30 mg/24h and mean uric acid >7 mg/dL weren’t statistically significant (P?0.05 value). CONCLUSIONS: An average glycated hemoglobin greater than 7% was associated with a greater decline in glomerular filtration rate, which favored the progress of diabetic nephropathy. Nephroprotection with inhibitors of RAAS delays the progression of diabetic kidney disease.
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Doença Renal Crónica Doença Renal Crónica Estadio 5 Nefropatia Diabética Progressão