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In conclusion, independent of microalbuminuria, cerebral microvascular disease predicted renal morbidity among patients with type 2 diabetes.Nephropathy in type 2 diabetes progresses from microalbuminuria to macroalbuminuria, and from macroalbuminuria to an elevated serum creatinine (Cr) concentration or the need for renal replacement therapy.The risk for the secondary renal end point of any dialysis or doubling of the serum creatinine concentration was also significantly higher for patients with SCI (hazard ratio, 4.79; 95% CI 2.72 to 8.46).The estimated GFR declined more in patients with SCI than in those without SCI; however, the presence of SCI did not increase the risk for progression of albuminuria.
Overall, 123 patients in the SCI group (69%) and 211 (49%) in the non-SCI group were treated with ACE inhibitors or ARBs.
There were also significant differences in the levels of serum Cr and estimated GFR (e GFR) between the two groups.
More patients with SCI had microalbuminuria and diabetic neuropathy.
Although the fasting plasma glucose and glycosylated hemoglobin levels were significantly higher in the SCI group than in the non-SCI group (Table 1), the glycosylated hemoglobin levels were not different between the two groups during the follow-up period (SCI group, 6.99% ± 1.01% Over the average 7.5-year follow-up period, 58 patients (34 in the SCI group and 24 in the non-SCI group) reached the primary composite end point of ESRD or death.
No patient showed recovery of renal function after starting renal replacement therapy.