Authors: Lo, M. K. W.¹; Lee, K.-F.²; Chan, N. N.³; Leung, W. Y. S.³; Ko, G. T. C.⁴; Chan, W.-B.³; So, W.-Y.³; Ng, M. C. Y.³; Ho, C.-S.⁵; Tam, J. S. L.⁶; Lam, C. W. K.⁵; Tong, P. C. Y.³; Chan, J. C. N.³

Source: Diabetes, Obesity and Metabolism, Volume 6, Number 3, May 2004 , pp. 223-230(8)

Publisher: Wiley-Blackwell

Abstract:

Background: 

The aim of this study was to investigate whether chronic infections with Helicobacter pylori and hepatitis B virus (HBV) might affect clinical outcomes in Chinese type 2 diabetic patients with advanced nephropathy. Methods: 

A prospective study of 97 type 2 diabetic patients with clinical proteinuria and renal insufficiency (median serum creatinine 200 µmol/l). Results: 

During a median follow-up period of 2 years, 34 developed end-stage renal disease (ESRD), 28 had cardiovascular endpoints and 11 patients had died (seven men and four women), and 52.7% developed a combined endpoint. Female patients had longer disease duration, higher blood pressure, lower body weight but higher serum creatinine and spot urine albumin : creatinine ratio as well as lower haemoglobin than male patients. On logistic regression analysis, female gender (hazard ratio: 5.91, p = 0.02), negative H. pylori serology (8.39, p = 0.004), baseline serum creatinine (1.04, p = 0.001) and haemoglobin (1.86, p = 0.01) were independent predictors for ESRD. Systolic blood pressure (1.04, p = 0.003), prior treatment with angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists (3.41, p = 0.04) and positive hepatitis B surface antigen (4.88, p = 0.025) were independent predictors for cardiovascular endpoints. Female gender (7.89, p = 0.002) and baseline serum creatinine (1.05, p < 0.001) were independent predictors for combined death and cardio-renal endpoints. Conclusions: 

In Chinese type 2 diabetic patients with clinical proteinuria renal insufficiency, there were high rates of death and cardio-renal outcomes. Female gender, low haemoglobin and negative H. pylori serology were important predictors for ESRD, whereas chronic HBV infection was associated with increased cardiovascular risks.

Keywords: diabetic nephropathy; end-stage renal disease; Helicobacter pylori; hepatitis B

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1462-8902.2004.00338.x

Affiliations: 1: Medical Unit, Pamela Youde Eastern Hospital, Hong Kong 2: Medical Unit, Tung Wah Hospital, Hong Kong 3: Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 4: Medical Unit, Alice Ho Nethersole Hospital, Hong Kong 5: Department of Chemical Pathology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 6: Department of Medical Microbiology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong

Publication date: 2004-05-01

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• By this author: Lo, M. K. W. ;  Lee, K.-F. ;  Chan, N. N. ;  Leung, W. Y. S. ;  Ko, G. T. C. ;  Chan, W.-B. ;  So, W.-Y. ;  Ng, M. C. Y. ;  Ho, C.-S. ;  Tam, J. S. L. ;  Lam, C. W. K. ;  Tong, P. C. Y. ;  Chan, J. C. N.

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