medigraphic.com
Colegio de Medicina Interna de México.

2023, Number 3

<< Back Next >>

Med Int Mex 2023; 39 (3)

Renal and thyroid function evaluation in diabetic and hypertensive patients in Tepic, Nayarit, Mexico

Delgado-Mejía M, Delgado-Astorga C, Paredes-Casillas P, González-González E, Calvo-Vargas C

Language: Spanish
References: 46
Page: 440-447
PDF size: 204.77 Kb.


ABSTRACT

Objective: To assess renal function in patients with type 2 diabetes mellitus and systemic arterial hypertension, comparing the creatinine clearance figures obtained by the Cockcroft-Gault formula with 24-hour urine creatinine clearance.
Materials and Methods: Observational and descriptive study conducted from January 2018 to January 2020, evaluating patients diagnosed with type 2 diabetes mellitus and systemic arterial hypertension, regardless of sex and over 30 years. Renal function was evaluated with the Cockcroft-Gault formula, compared against the measurement of creatinine clearance in 24-hour urine in the laboratory. All patients underwent additional thyroid function tests.
Results: One hundred eleven patients with type 2 diabetes were evaluated (41 men and 70 women), of them, 99 (89%) had additional diagnosis of arterial hypertension. Correlation of 0.659 was found, T value 2.67 and a -0.001 p value, indicating that both, the Cockcroft-Gault formula and the creatinine clearance in 24 hours can give precision in the results. Out of the 111 patients, 35 (31.5%) had abnormal tests of thyroid dysfunction.
Conclusions: Cockcroft-Gault formula is useful for monitoring the renal function of patients, given the lack of 24-hour urine creatinine clearance in the laboratory.


REFERENCES

  1. Kasper, Fauci, Hauser, Longo, Jameson, Loscalzo, Harrison.Principles of Internal Medicine. 19ª ed. 2016; vol. 2.

  2. Van den Berg BM, Wang G, Boels MGS, Avramut MC, etal. Glomerular function and Structural integrity dependon hyaluronan synthesis by glomerular endothelium.J Am Soc Nephrol 2019; 30:1886-97. doi: 10.1681/ASN.2019020192.

  3. Assady S, Benzing T, Kretzler M, Skorecki KL. Glomerularpodocytes in kidney health and disease. Lancet 2019; 393:856-8. https://doi.org/10.1016/S0140-6736(18)33000-9.

  4. Fissell WH, Miner JH. What is the glomerular ultrafiltrationbarrier? J Am Soc Nephrol 2018; 29: 2262-4. 10.1681/ASN.2018050490.

  5. GBD Chronic Kidney Disease Collaboration. Global, regional,and national burden of chronic kidney disease,1990-2017: A systematic analysis for the Global Burdenof Disease Study 2017. Lancet 2020; 395: 709-33. doi:10.1016/S0140-6736(20)30045-3.

  6. Adler AL, Stevens RJ, Manley SE, Holman RR. Developmentand progression of nephropathy in type 2 diabetes:The United Kingdom Prospective Diabetes Study (UKPDS64). Kidney Int 2003; 63: 225-32. doi: 10.1046/j.1523-1755.2003.00712.x.

  7. Alegre-Díaz J, Herrington W, López-Cervantes M, RamírezR, et al. Diabetes and cause-specific mortality in MexicoCity. N Engl J Med 2016; 375: 1961-71.

  8. Astudillo O. Country in focus: Mexico’s growing obesity problem.Lancet Diabetes Endocrinol 2014; 2: 15-16. https://doi.org/10.1016/S2213-8587(13)70160-8.

  9. Rawshani A, Rawshani A, Franzen S, Eliasson B, et al. Riskfactors, mortality, and cardiovascular outcomes in patientswith type 2 diabetes. N Engl J Med 2018; 379: 633- 44. doi:

  10. 10.1056/NEJMoa1800256.10. Rawshani A, Rawshani A, Gudbjörnsdottir S. Mortality andcardiovascular disease in type 1 and type 2 diabetes. N EnglJ Med 2017; 376: 1407-18. doi: 10.1056/NEJMc1706292.

  11. Menke A, Casagrande S, Geisss L, Cowie-CC. Prevalenceof and trends in diabetes among adults in the UnitedStates, 1988-2012. JAMA 2015; 314: 1021-9. doi: 10.1001/jama.2015.10029.

  12. Ettehad D, Emdin CA, Kiran A, Anderson SG, et al. Bloodpressure lowering for prevention of cardiovascular diseaseand death: a systematic review and meta- analysis. Lancet2016; 387: 957-67. doi: 10.1016/S0140-6736(15)01225-8.

  13. Colchero MA, Popkin BM, Rivera JA, Ng SW. Beverage purchasesfrom stores in Mexico under the excise tax on sugarsweetened beverages: observational study. BMJ 2016; 352:h6704. https://doi.org/10.1136/bmj.h6704.

  14. Calvo-Vargas CG, Rubio-Guerra AF, Galarza-Delgado D,García C, Delgado-Mejía M. Eficacia del valsartán y la hidroclorotiazidaen el tratamiento de la hipertensión arterialesencial. Estudio realizado mediante la automedición apréstamo de la presión arterial. Med Int Mex 2002; 18(2): 67-74.

  15. Hayward RA, Reaven PD, Witala WL, Bahn GD, et al. Followupof glycemic control and cardiovascular outcomes intype 2 diabetes. N Engl J Med 2015; 372: 2197-206. doi:10.1056/NEJMoa1414266.

  16. Delgado-Mejía M, Delgado C, Ávalos T, Paredes P, GonzálezE. Control and evaluation of microalbuminuria in a populationof the state of Nayarit, Mexico. Study conductedby self—measurement on loan of blood pressure. MedInt Mex 2018; 34 (6): 864-873. https://doi.org/10.24245/mim.v34i6.2617.

  17. Logue J, Walker JJ, Leese G, Lindsay R, et al. Associationbetween BMI measured within a year after diagnosis oftype 2 diabetes and mortality. Diabetes Care 2013; 36:887-93. doi: 10.2337/dc12-0944.

  18. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA,et al, for STAMPED Investigators. Bariatric surgery versusintensive medical therapy for diabetes — 3-year outcomes.N Engl J Med 2014; 370: 2002-13. DOI: 10.1056/NEJMoa1401329.

  19. Brethauer PR, Aminian A, Romero-Talamas H, et al. Candiabetes be surgically cured? Long-term metabolic effectsof bariatric surgery in obese patients with type 2 diabetesmellitus. Ann Surg 2013; 258: 628-36. doi: 10.1097/SLA.0b013e3182a5034b.

  20. Ikramuddin S, Korner J, Lee WJ, Connett JE, et al. Roux-en-Ygastric bypass vs Intensive Medical management for thecontrol of type 2 diabetes, Hypertension, and hyperlipidemia:the Diabetes Surgery study randomized clinical trial.JAMA 2013; 309: 2240-9. doi: 10.1001/jama.2013.5835.

  21. Kaplan NM. Clinical hypertension. Baltimore: Williams &Wilkins, 2014.

  22. Marso SP, Bain SC, Consoli A, Eliaschewitz FG, et al. Semaglutideand cardiovascular outcomes in patients with type2 diabetes. N Engl J Med 2016; 375: 311-22. DOI: 10.1056/NEJMoa1607141.

  23. Stanton RC. Clinical challenges in diagnosis and managementof diabetic kidney disease. Am J Kidney Dis 2014; 63(Suppl 2): S3-21. doi: 10.1053/j.ajkd.2013.10.050.

  24. Zinman B, Wanner C, Lachin JM, Fitchett D, et al. Empagliflozin,cardiovascular outcomes, and mortality in type 2diabetes. N Engl J Med 2015; 373: 2117-28. DOI: 10.1056/NEJMoa1504720.

  25. Kelsey MM, Zeitler PS. Insulin resistance of puberty. CurrDiab Rep 2016; 16: 64. doi: 10.1007/s11892-016-0751-5.

  26. Stringhini S, Batty GD, Bovet P, Shipley MJ, et al. Associationof life-course socioeconomic status with chronicinflammation and type2 diabetes risk: tha Witehall 11prospective cohort study. Plus Med 2013; 10 (7): e1001479.doi: 10.1371/journal.pmed.1001479.

  27. The ACCORD Study Group. Nine-year effects of 3.7 yearsof intensive glycemic control on cardiovascular outcomes.Diabetes Care 2016; 39: 701-708. doi: 10.2337/dc15-2283.

  28. 29. Tancredi M, Rosengren A, Svensson AM, KosiborodM, et al. Excess mortality among persons with type 2diabetes. N Engl J Med 2015; 373: 1720-32. DOI: 10.1056/NEJMoa1504347.

  29. Reaven PD, Emanuele NV, Wiitala WL, Bahn GD, et al.Intensive glucose control in patients with type 2 diabetes— 15-year follow-up. N Engl J Med 2019; 380: 2215- 24.DOI: 10.1056/NEJMoa1806802.

  30. Diabetes Control and Complications Trial (DCCT)/Epidemiologyof Diabetes Interventions and Complications (EDIC)Study Research Group. Intensive diabetes treatment andcardiovascular outcomes in type 1 diabetes: the DCCT/EDICStudy 30-year follow-up. Diabetes Care 2016; 39: 686-93.doi: 10.2337/dc15-1990.

  31. Levey AS, Coresh J, Balk E, Kausz AT, et al. National KidneyFoundation practice guidelines for chronic kidney diseaseevaluation, classification, and stratification. Ann InternMed 2003; 139: 137-147. doi: 10.7326/0003-4819-139-2-200307150-00013.

  32. Dwyer JP, Parvging HH, Ravid M, RamuzziG, Lewis JB. Renaldysfunction in the presence of normoalbuminuria in type2 diabetes; results from the DEMAND study. CardiorenalMed 2012; 2 (1): 1-10. doi: 10.1159/000333249.

  33. Emdin CA, Rahimi K, Neal B, Callender T, Perkovic V, PatelA. Blood pressure lowering in type 2 diabetes : a systematicreview and meta-analysis. JAMA 2015; 313 (6): 603-615.doi: 10.1001/jama.2014.18574.

  34. Benzing T, Salant D. Insights into glomerular filtrationand albuminuria. N Engl J Med 2021; 384: 1437-46. doi:10.1056/NEJMra1808786.

  35. Hu Y, Zong G, Liu G, Wang M, et al. Smoking cessation,weight change, type 2 diabetes , and mortality. N Engl JMed 2018; 379: 623-32. DOI: 10.1056/NEJMoa1803626.

  36. Twig G, Yaniv G, Levine H, Leiba A, et al. Body-mass indexin 2.3 million adolescents and cardiovascular deathin adulthood . N Engl J Med 2016; 374: 2430-40. DOI:10.1056/NEJMoa1503840.

  37. Shah RV, Murphy VL, Colangelo LA, Reis J, et al. Associationof fitness in young adult-hood with survival and cardiovascularrisk: the Coronary Artery Risk Development inYoung Adults (CARDIA) Study. JAMA 2016; 176: 87-95.doi: 10.1001/jamainternmed.2015.6309.

  38. Appel GB, Radhakrishnan J, Avram MM, Defronzo RA, etal. Analysis of metabolic parameters as predictors of riskin the RENAAL Study. Diabetes Care 2003; 26: 1402-1407.doi: 10.2337/diacare.26.5.1402.

  39. Koye DN, Magliano DJ, Nelson RG, Pavkov ME. The globalepidemiology of diabetes and kidney disease. AdvChronic Kidney Dis 2018; 25 (2): 121-132. https://doi.org/10.1053/j.ackd.2017.10.011.

  40. Bjerregaard JG, Jensen BW, Angquist L, Osler M, et al. Changein overweight from childhood to early adulthood andrisk of type 2 diabetes. 2018; 378: 1302-12. DOI: 10.1056/NEJMoa1713231.

  41. Aarestrup J, Bjerregaard LG, Gamborg M, Angquist L, et al.Tracking of body mass index from 7 to 69 years of age. Int JObes (Lond) 2016; 40: 1376-83. doi: 10.1038/ijo.2016.88.

  42. Zimmermann E, Bjerregaard LG, Gamborg M, Vaag AA, etal. Childhood body mass index and development of type2 diabetes throughout adult life: a large-scale Danish cohortstudy. Obesity (Silver-Spring) 2017; 25: 965-71. doi:10.1002/oby.21820.

  43. Jali MV, Kambar S, Jali SM, Pawar N, Nalawade P. Prevalenceof thyroid dysfunction among type 2 diabetes mellituspatients. Diabetes Metab Syndr 2016. doi: 10.1016/j.dsx.2016.12.017.

  44. Han C, He X, Xia X, Li Y. Subclinical hypothyroidism andtype 2 diabetes: Systematic review and meta-analysis.PLoS One 2015; 10 (8): e135233. doi: 10.1371/journal.pone.0135233.

  45. Bishop M. Clinical chemistry. Textbook of Principles. Techniquesand Correlations. 2017.

  46. Tietz. Textbook of clinical chemistry and molecular diagnostics.2017.




2020     |     www.medigraphic.com