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Weighted prevalence of albuminuria according to kidney function in diabetic patients in the Korea National Health and Nutrition Examination Survey 2011-2014
( Yoon Ji Kim ) , ( Kyoung Yeon Jung ) , ( Kyoung Min Kim ) , ( Jae Hoon Moon ) , ( Sung Hee Choi ) , ( Kyong Soo Park ) , ( Hak Chul Jang ) , ( Soo Lim )
UCI I410-ECN-0102-2021-500-000693060
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Objective: Diabetes is the most common underlying cause of end-stage renal disease (ESRD). Increased albuminuria is an independent risk factor for developing diabetic nephropathy. However, recent data have shown that many diabetic patients have low estimated glomerular filtration rate (eGFR) but no albuminuria. We investigated the prevalence of normoalbuminuria and albuminuria in diabetic patients with or without chronic kidney disease (CKD) using a large-cohort study. Methods: We used adults from the Korea National Health and Nutrition Examination Survey (KNHANES) 2011-2014 (n = 23,688) where urine albumin levels were measured. CKD was defined as eGFR < 60 mL/min/1.73m2. Albuminuria was defined as urinary albumin-to-creatinine ratio (ACR) ≥ 30 mg/g. Because the KNHANESs were based on complex sampling design, weighted frequency and prevalence were examined using survey procedure. Results: Among 23,688 participants, 1,977 had diabetes. Their mean ± SE of age was 56.5 ± 0.5 years in men and 61.5 ± 0.5 years in women. Their mean ± SE of BMI was 24.9 ± 0.1 kg/m2 in men and 25.6 ± 0.2 kg/m2 in women, respectively. In these diabetic populations, 1,746 had normal kidney function and 231 had CKD. Among diabetic patients with normal kidney function, 20% had albuminuria (n = 372). In contrast, among 231 diabetic CKD patients, 51.1% had normoalbuminuria (n = 119). Conclusion: In this study using the KNHANES 2011-2014, we found that 20% of Korean diabetic patients with normal kidney function had albuminuria. So, we need to examine albuminuria in all diabetic patients even with normal eGFR. In contrast, more than 50% of Korean diabetic CKD patients had normoalbuminuria. Therefore, it would be prudent to investigate other contributing factors to renal impairment in this group.

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