Large kidneys predict poor renal outcome in subjects with diabetes and chronic kidney disease. - Inserm - Institut national de la santé et de la recherche médicale Accéder directement au contenu
Article Dans Une Revue BMC Nephrology Année : 2010

Large kidneys predict poor renal outcome in subjects with diabetes and chronic kidney disease.

Résumé

BACKGROUND: Renal hypertrophy occurs early in diabetic nephropathy, its later value is unknown. Do large kidneys still predict poor outcome in patients with diabetes and Chronic Kidney Disease (CKD)? METHODS: Seventy-five patients with diabetes and CKD according to a Glomerular Filtration Rate (GFR, by 51Cr-EDTA clearance) below 60 mL/min/1.73 m2 or an Albumin Excretion Rate above 30 mg/24 H, had an ultrasound imaging of the kidneys and were cooperatively followed during five years by the Diabetology and Nephrology departments of the Centre Hospitalier Universitaire de Bordeaux. RESULTS: The patients were mainly men (44/75), aged 62 +/- 13 yrs, with long-standing diabetes (duration:17 +/- 9 yrs, 55/75 type 2), and CKD: initial GFR: 56.5 (8.5-209) mL/min/1.73 m2, AER: 196 (20-2358) mg/24 H. Their mean kidney lenght (108 +/- 13 mm, 67-147) was correlated to the GFR (r = 0.23, p < 0.05). During the follow-up, 9/11 of the patients who had to start dialysis came from the half with the largest kidneys (LogRank: p < 0.05), despite a 40% higher initial isotopic GFR. Serum creatinine were initially lower (Small kidneys: 125 (79-320) micromol/L, Large: 103 (50-371), p < 0.05), but significantly increased in the "large kidneys" group at the end of the follow-up (Small kidneys: 129 (69-283) micromol/L, Large: 140 (50-952), p < 0.005 vs initial). The difference persisted in the patients with severe renal failure (KDOQI stages 4,5). CONCLUSIONS: Large kidneys still predict progression in advanced CKD complicating diabetes. In these patients, ultrasound imaging not only excludes obstructive renal disease, but also provides information on the progression of the renal disease.
Fichier principal
Vignette du fichier
1471-2369-11-3.pdf (290.37 Ko) Télécharger le fichier
1471-2369-11-3.xml (70.02 Ko) Télécharger le fichier
Origine : Fichiers éditeurs autorisés sur une archive ouverte
Format : Autre
Loading...

Dates et versions

inserm-00663526 , version 1 (27-01-2012)

Identifiants

Citer

Vincent Rigalleau, Magalie Garcia, Catherine Lasseur, François Laurent, Michel Montaudon, et al.. Large kidneys predict poor renal outcome in subjects with diabetes and chronic kidney disease.. BMC Nephrology, 2010, 11 (1), pp.3. ⟨10.1186/1471-2369-11-3⟩. ⟨inserm-00663526⟩

Collections

INSERM
149 Consultations
344 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More