Coronary artery disease is the major determinant of excess mortality in patients with insulin-dependent diabetes mellitus and persistent proteinuria

The goal of this review was to assess the magnitude of coronary artery disease (CAD) mortality and its determinants in insulin-dependent diabetes mellitus (IDDM) patients with persistent proteinuria. By reanalyzing data from two previously published studies of patients with nephropathy, it was found...

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Bibliographic Details
Published in:Journal of the American Society of Nephrology 1992-10, Vol.3 (4 Suppl), p.S104-S110
Main Authors: Warram, J H, Laffel, L M, Ganda, O P, Christlieb, A R
Format: Article
Language:English
Subjects:
Adult
Age Factors
Blood Pressure
Cholesterol - blood
Coronary Disease - complications
Coronary Disease - mortality
Coronary Disease - physiopathology
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 1 - mortality
Diabetes Mellitus, Type 1 - physiopathology
Diabetic Nephropathies - complications
Diabetic Nephropathies - mortality
Diabetic Nephropathies - physiopathology
Humans
Middle Aged
Proteinuria - complications
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Summary:The goal of this review was to assess the magnitude of coronary artery disease (CAD) mortality and its determinants in insulin-dependent diabetes mellitus (IDDM) patients with persistent proteinuria. By reanalyzing data from two previously published studies of patients with nephropathy, it was found that these patients had extremely high CAD mortality rates in comparison with IDDM patients without proteinuria, but only after the age of 35 yr. In addition, the risk of CAD death was associated with high serum cholesterol levels but was unrelated to systemic blood pressure, smoking habits, and obesity. Further studies of the determinants of CAD in patients with IDDM and proteinuria are urgently needed. Except for efforts to lower serum cholesterol, it is not known whether any other measure can be undertaken to reduce the extremely high mortality due to CAD that afflicts IDDM patients with persistent proteinuria, in particular those patients whose renal failure might have been "successfully" postponed by antihypertensive therapy.
ISSN:1046-6673
DOI:10.1681/ASN.V34s104