Analysis of clinical features of patients with type 2 diabetes mellitus with different levels of glomerular filtration rate

Abstract

Aim to improve the dispensary follow-up of patients with type 2 diabetes (DM) by identifying clinical signs, available during examination in the outpatient clinic, that suggest the development of chronic kidney disease (CKD). Material and methods. A cross-sectional study included a population sample of patients with type 2 diabetes and focused on the clinical indices available during an outpatient consultation. 150 protocols of outpatient consultations were selected using the compliance criteria, including data on 72 clinical indices. The general sample was divided into groups in two ways: by the level of glomerular filtration rate (GFR) and by achieving the goals of glycemic control (calculated parameter delta HbA1c). Results. The following indices differed most significantly in the groups divided by stages of CKD: gender, age, duration of diabetes and insulin therapy, achievement of target values of glycemic control, blood pressure level, comorbid cardiovascular pathology, pulse on the popliteal artery. In patients with preserved GFR and the early stages of CKD, the fact of unsatisfactory glycemic control was associated with an increase in plasma creatinine and a decrease in GFR, higher blood pressure values. In the advanced stages of CKD, the impact of glycemic control on kidney function was practically absent.