Peculiarities of the course of diabetic kidney disease in patients with latent autoimmune diabetes in adults

Main Article Content

I.O. Tsaryk
N.V. Pashkovska

Abstract

Background. Latent autoimmune diabetes in adults (LADA) is a heterogeneous type of diabetes mellitus (DM) that combines symptoms of type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Data about the frequency and structure of microvascular complications in LADA are small and quite contradictory, there is almost no information about the peculiarities of their course, which indicates the need for research in this area. Therefore, the purpose of the study was to determine the characteristics of diabetic kidney disease (DKD) in patients with latent autoimmune diabetes in adults compared with classical types of DM. Materials and methods. The study enrolled 112 patients with DM with DKD. Patients were divided into three groups: I — 54 people with LADA, II — 30 patients with T1DM, III — 28 patients with T2DM. Peculiarities of DKD course were studied based on the anamnesis data, clinical examination, glomerular filtration rate (GFR) values, albuminuria, albumin-creatinine ratio. Results. According to the anamnesis the diagnosis of DKD in patients with LADA was established on average 3 years after the manifestation of diabetes, which is 4.5 years earlier than in T1DM but 1.3 years later than in T2DM. The analysis of GFR stages showed that in LADA the category G3 was the most often (63 %) (G3a — in 46 %, G3b — in 17 %). The other patients had G1 stage (7 %), G2 stage (24 %), and only 6 % of patients had G4 stage. The albuminuria categories A1 and A2 predominated in patients of all groups (in LADA — 43 % of people in each category), while category A3 in LADA was registered twice as often as in T1DM. In LADA, the predominant phenotypes were non-albuminuric renal impairment (NARI) (43 %) and albuminuric phenotype (AP) (35 %), in T1DM — AP (50 %) and NARI (40 %), and in T2DM, all three phenotypes were registered with almost the same frequency (AP — in 32 %, NARI — in 29 %, progressive renal decline — in 39 %). Conclusions. The course of diabetic kidney disease in patients with latent autoimmune diabetes in adults differs from that in the classic types of diabetes, which indicates the need to develop a specific algorithm for this cohort of patients.

Article Details

How to Cite
Tsaryk, I., and N. Pashkovska. “Peculiarities of the Course of Diabetic Kidney Disease in Patients With Latent Autoimmune Diabetes in Adults”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 17, no. 2, May 2021, pp. 116-20, doi:10.22141/2224-0721.17.2.2021.230565.
Section
Original Researches

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