Improved survival in patients with diabetic nephropathy (original) (raw)

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The effect of early antihypertensive treatment on survival of patients with diabetic nephropathy was evaluated by studying two cohorts of Type 1 (insulin-dependent) diabetic patients developing persistent proteinuria in I: 1957–1973 (late treatment group _n_=49) and II: 1979–1983 (early treatment group_n_=71). At onset of nephropathy, the two cohorts were comparable with regard to age (29(8) vs 30(8) years, mean (SD)), duration of diabetes (16(6) vs 18(7) years), blood pressure (132(16)/85(11) vs 134(16)/86(8) mm Hg), proteinuria (0.8 (0.5–1.2) vs 0.8 (0.6–1.2) g × 24 h−1, median (quartiles)) and serum creatinine (87(14) vs 85(16) μmol×1−1). The patients were followed frequently at the outpatients’ clinic until death or for a median duration of 8 years. In the first cohort antihypertensive treatment was seldom used, whereas, in the second cohort antihypertensive treatment was started when blood pressure reached 144(18)/93(7) mm Hg. The probability of survival with a functioning kidney for more than 8 years was 48% in the first cohort and 87% in the second cohort, p<0.001. The improvement of survival was due mainly to a decreased mortality from uraemia. Early antihypertensive treatment is the most likely explanation for this improvement.

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Authors and Affiliations

  1. Steno Memorial Hospital, Gentofte
    E. R. Mathiesen, K. Borch-Johnsen, D. V. Jensen & T. Deckert
  2. Hvidøre Hospital, Klampenborg, Denmark
    E. R. Mathiesen

Authors

  1. E. R. Mathiesen
  2. K. Borch-Johnsen
  3. D. V. Jensen
  4. T. Deckert

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Mathiesen, E.R., Borch-Johnsen, K., Jensen, D.V. et al. Improved survival in patients with diabetic nephropathy.Diabetologia 32, 884–886 (1989). https://doi.org/10.1007/BF00297455

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