508-P: Single and Joint Impact of Type 2 Diabetes and of Congestive Heart Failure on Albuminuria

Albuminuria is a characteristic feature of diabetic nephropathy, and urine albumin excretion is also increased in patients with congestive heart failure (CHF). However, no data are available on the single and joint associations of type 2 diabetes (T2DM) and CHF with albuminuria. This issue therefore was addressed in the present study. We investigated 181 patients with CHF, of whom 84 had T2DM (CHF+/T2DM+) and 97 did not have diabetes (CHF+/T2DM-) and 413 controls without CHF, of whom 79 had T2DM (CHF-/T2DM+) and 334 did not have diabetes (CHF-/T2DM-). The albumin/creatinine ratio (ACR) was 34±117 in CHF-/T2DM- patients. Compared to this group it was higher in CHF-/T2DM+ patients (56±110; p=0,002), in CHF+/T2DM- patients (98±311; p<0,001) and in CHF+/T2DM+ patients (286±779; p<0,001), in whom in turn it was higher than in CHF-/T2DM+ (p<0,001) or in CHF+/T2DM- (p=0,001) patients. The ACR did not differ significantly between CHF-/T2DM+ and CHF+/T2DM- patients (p=0,345). In multivariate analysis of covariance, T2DM and CHF proved to be independent predictors of the ACR after adjustment for age, sex, body mass index, LDL-C, smoking and hypertension (F=6,392; p=0,012 and F=13,14; p=<0,001, respectively). We conclude that T2DM and CHF are mutually independent determinants of albuminuria.