Albuminuria is a well-known characteristic of diabetic nephropathy and it is also present in a large portion of patients with congestive heart failure (CHF). However, the single and joint effects of type 2 diabetes mellitus (T2DM) and CHF on albuminuria are unknown. This issue therefore was addressed in the present study.

We investigated 180 patients with CHF, of whom 83 had T2DM (CHF+/T2DM+) and 97 did not have diabetes (CHF+/T2DM-) and 223 controls without CHF, of whom 39 had T2DM (CHF-/T2DM+) and 184 did not have diabetes (CHF-/T2DM-).

The prevalence of albuminuria was lowest in CHF-/T2DM- subjects (8.7%). When compared to this group it was significantly higher in CHF-/T2DM+ (23.1%, p=0.010), CHF+/T2DM- (38.1%, p<0.001) and CHF+/T2DM+ patients (62.7%, p<0.001). It was highest in CHF+/T2DM+ patients, in whom it was higher than in CHF-/T2DM+ (p<0.001) and in CHF+/T2DM- (p=0.001) patients; a trend towards a higher prevalence of albuminuria in CHF-/T2DM+ patients vs. CHF+/T2DM- patients did not reach statistical significance (p=0.093). In logistic regression analysis, CHF and T2DM were mutually independent predictors of albuminuria, when adjusted for age, sex, body mass index, LDL cholesterol, history of smoking and hypertension, as well as for the use of statins and ACE inhibitors/angiotensin II receptor blockers (OR 2.57 [95% CI 1.47-4.51]; p=0.001 and OR 4.15 [2.18 - 7.88]; p<0.001, respectively).

We conclude that T2DM and CHF are mutually independent predictors of albuminuria.

Disclosure

M. Maechler: None. C. H. Saely: None. A. Vonbank: None. B. Larcher: None. A. Mader: None. L. Sprenger: None. B. Mutschlechner: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None.

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