Similar rate of progression in the predialysis phase in type I and type II diabetes mellitus

Biesenbach, Georg; Janko, O; Zazgórnik, J

doi:10.1093/ndt/9.8.1097

Cited by 117 publications

(69 citation statements)

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“…However, arterial blood pressure was significantly higher in smokers than in nonsmokers (159/89 vs. 141/82 mmHg). Unfortunately, the levels of albuminuria were not presented (24).…”

Section: Discussionmentioning

confidence: 99%

“…In summary, the above-mentioned studies are characterized by a small number of patients with overt diabetic nephropathy (20,23,24), short duration of follow-up (23), inadequate methods of urine collection (20), missing information on albuminuria (23,24), and most important, inaccurate methods of estimating the decline in kidney function using serum creatinine (20,23) or creatinine clearance (23,24). To obtain valid determination of the rate of decline in GFR, the following requirements should be fulfilled: the applied GFR method should have good accuracy and precision, repeated measurements of GFR should be performed (approximately every 6 -12 months), and the observation period should be extended to at least 2 years (25).…”

Section: Discussionmentioning

confidence: 99%

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Smoking and Progression of Diabetic Nephropathy in Type 1 Diabetes

Hovind

Rossing²,

Tarnow³

et al. 2003

Diabetes Care

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OBJECTIVE -Cigarette smoking contributes to development of diabetic nephropathy. However, long-term studies on the effect of smoking on decline in kidney function in diabetic nephropathy are lacking. We assessed the impact of smoking on progression of diabetic nephropathy in type 1 diabetic patients enrolled in a prospective observational cohort study started in 1983.RESEARCH DESIGN AND METHODS -We identified all albuminuric type 1 diabetic patients (n ϭ 301) followed for at least 3 years, median (range) 7 years (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), who underwent at least yearly measurement of glomerular filtration rate (GFR) by the 51 Cr-EDTA plasma clearance technique (n ϭ 8, range 3-24). In total, 192 men and 109 women were included (age [mean Ϯ SD] 36 Ϯ 11 years, duration of diabetes 22 Ϯ 8 years); 271 patients were treated with antihypertensive drugs, predominantly ACE inhibitors in 179 patients. Patients were classified as smokers if they smoked more than one cigarette per day during a portion of or the entire observation period. Blood pressure, albuminuria, HbA 1c , and serum cholesterol were measured every 3-4 months during the study. RESULTS -In all 301 patients, the mean (SE) rate of decline in GFR (⌬GFR) was 4.0 (0.2) ml ⅐ min -1 ⅐ year -1 during the investigation period. No difference in ⌬GFR was demonstrated between nonsmokers (n ϭ 94), ⌬GFR 4.5 (0.4), ex-smokers (n ϭ 31), ⌬GFR 3.1 (0.7), and smokers (n ϭ 176), ⌬GFR 3.9 (0.3) ml ⅐ min -1 ⅐ year -1 , respectively (NS). Adjustment for other risk factors for progression of diabetic nephropathy did not alter the results: smoking was not associated with ⌬GFR, whereas blood pressure, albuminuria, HbA 1c , and serum cholesterol were demonstrated to be independent progression promoters.CONCLUSIONS -In our study, smoking was not associated with decline in kidney function in type 1 diabetic patients with diabetic nephropathy. Diabetes Care 26:911-916, 2003

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“…However, arterial blood pressure was significantly higher in smokers than in nonsmokers (159/89 vs. 141/82 mmHg). Unfortunately, the levels of albuminuria were not presented (24).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Smoking and Progression of Diabetic Nephropathy in Type 1 Diabetes

Hovind

Rossing²,

Tarnow³

et al. 2003

Diabetes Care

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“…Intriguingly, smoking also increases the risk of subjects to develop type Ⅱ diabetes, possibly because it increases insulin resistance [62] . Furthermore, a growing body of evidence compared non-diabetic smokers and non-smokers and found that smokers were more insulin resistant and hyperinsulinemic [63] . Furthermore, smoking impaired insulin action, mainly due to a lowering of peripheral glucose uptake [64] ; thus, smoking is a key risk factor for the subject to develop type Ⅱ diabetes and secondary complications.…”

Section: Comradeship Between Smoking and Diabetic Nephropathy: Exacermentioning

confidence: 99%

Smoking in diabetic nephropathy: sparks in the fuel tank?

Chakkarwar¹

2012

WJD

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Diabetic nephropathy is associated with high morbidity and mortality and the prevalence of this disease is continuously increasing worldwide. Long-term diabetes increases the likelihood of developing secondary complications like nephropathy, the most common cause of end stage renal disease. Usually, other factors like hypertension, alcoholism and smoking also partly contribute to the progression of diabetic nephropathy. Among this, cigarette smoking in diabetes has been repeatedly confirmed as an independent risk factor for the onset and progression of diabetic nephropathy. Various studies suggest that smoking is a major fuel in the development of high oxidative stress and subsequently hyperlipidemia, accumulation of advanced glycation end products, activation of the renin angiotensin system and Rho-kinase, which are observed to play a pathogenic role in the progression of diabetic nephropathy. Furthermore, cigarette smoking in diabetic patients with vascular complications produces a variety of pathological changes in the kidney, such as thickening of the glomerular basement membrane and mesangial expansion with progression in glomerulosclerosis and interstitial fibrosis, which ultimately results in end stage renal failure. Strong associations are consistently found between chronic cigarette smoking and diabetic microvascular complications. A diverse group of studies unveil potential mechanisms that may explain the role of cigarette smoking in the progression of diabetic nephropathy. Tremendous efforts are being made to control smoking mediated progression of diabetic nephropathy, but no promising therapy is yet available. The present review critically discusses the possible detrimental role of chronic cigarette smoking in the progression of diabetic nephropathy and various possible pharmacological interventions to attenuate the exacerbation of diabetic nephropathy.

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“…The available literature documents that smoking (1) increases the risk to develop microalbuminuria (14,20 -30), (2) accelerates the rate of progression from microalbuminuria to manifest proteinuria (31)(32)(33)(34)(35)(36), and (3) accelerates progression of renal failure (32,(37)(38)(39)(40).…”

Section: Adverse Renal Effects Of Smoking In Patients With Renal Diseasementioning

confidence: 99%

“…Another prospective study investigated the progression rate in the predialysis phase. Sixteen patients with type 1 diabetes and 16 patients with type 2 diabetes were studied (37). At study-entry, all patients had near-normal renal function and overt proteinuria.…”

Section: Adverse Renal Effects Of Smoking In Patients With Renal Diseasementioning

confidence: 99%