Características de los pacientes diabéticos referidos por primera vez a las consultas de atención especializada de Nefrología

BACKGROUND: Diabetic nephropathy (DN) has become the main cause of end-stage renal disease. In our country, this problem is specially relevant in Canary Islands, where DN is the cause of renal failure in 39% of patients included in dialysis programs. The importance of this situation and the relevance of an adequate referral to the nephrologist, prompt us to study the characteristics of diabetic patients referrred to our outpatient clinic. SUBJECTS AND METHODS: One-hundred and fifty patients with diabetes consecutively referred to the outpatient nephrology clinic at the Hospital Universitario Nuestra Senora de Candelaria were included in the study. We analysed demographic and epidemiologic characteristics, therapeutic strategies, as well as serum and urine biochemical parameters. RESULTS: Ninety-eight percent of patients suffered from type 2 diabetes, and 90% were referred by the primary physician. Renal insufficiency and proteinuria were the main causes of referral (48% and 30.6%, respectively). Overweight or obesity were present in 82.6% of patients, 97% were hypertensive and 92.6% presented dyslipidemia. Medical history of cardiovascular disease was present 16% of patients. Two-thirds of patients had a creatinine clearance below 60 ml/min. One-third of patients did not receive therapy with blockers of the renin-angiotensin system, and only 37% were treated with statins. CONCLUSIONS: An elevated percentage of diabetic patients referred to nephrologist did not reach the recommended therapeutic goals. These findings prompt us to reflect on the therapeutic approach in these patients and the referral to the nephrologist.