Normoalbuminuric diabetic kidney disease in the U.S. population

J Diabetes Complications. 2013 Mar-Apr;27(2):123-7. doi: 10.1016/j.jdiacomp.2012.09.010. Epub 2012 Nov 24.

Abstract

Background: This study sought to compare the prevalence and modifying factors of normoalbuminuric (NA) versus albuminuric (ALB) CKD in the U.S. diabetic and nondiabetic populations.

Methods: NHANES 2001-2008 included 2798 diabetic and 15,743 nondiabetic participants. Age-specific prevalence of NA-CKD and ALB-CKD was calculated within each diabetes stratum and then stratified again according to gender, ethnicity, mean arterial pressure ≥105 mmHg and HbA1c≥7%. Multivariate regression analyses were performed to determine odds ratios and 95% CI for NA-CKD.

Results: Prevalence of NA-CKD rose with age, with an overall mean of 9.7% in diabetic and 4.3% in nondiabetic participants. NA-CKD was less prevalent in diabetic men, OR=0.58 (95% CI: 0.39, 0.87). In comparison with whites, blacks and 'other' ethnic groups had an OR for NA-CKD of 0.44 (95% CI 0.29, 0.68) and 0.57 (95% CI: 0.34, 0.96), respectively. Poorly controlled blood pressure and glycemia resulted in a decreased OR for NA-CKD (OR = 0.25, 95% CI: 0.13, 0.50) and (0.48, 95% CI: 0.31, 0.74), respectively. Similar results were obtained for nondiabetic participants.

Conclusions: NA-CKD is more common in people with diabetes, women, non-Hispanic whites, and in the setting of well controlled blood pressure and glycemia.

MeSH terms

  • Age Factors
  • Albuminuria / etiology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / therapy
  • Diabetic Nephropathies / epidemiology*
  • Diabetic Nephropathies / etiology
  • Diabetic Nephropathies / physiopathology
  • Diabetic Nephropathies / urine
  • Female
  • Health Surveys
  • Humans
  • Hyperglycemia / etiology
  • Hyperglycemia / physiopathology
  • Hypertension / complications
  • Hypertension / physiopathology
  • Male
  • Prevalence
  • Regression Analysis
  • Renal Insufficiency / complications
  • Renal Insufficiency / epidemiology*
  • Renal Insufficiency / etiology
  • Renal Insufficiency / physiopathology
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / etiology
  • Renal Insufficiency, Chronic / physiopathology
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • United States / epidemiology