[Nephrotic syndrome in diabetis: evolution and prognosis about 35 cases]

ABSTRACT

The objective of our study was to evaluate the prognostic factors in the nephritic diabetic syndrome and its evolution. We realized a retrospective study of 35 cases of diabetic patients hospitalized between 1985 and 1999 who presented with a nephrotic syndrome. They included 17 females and 18 males, their mean age was 43 years [extremes 18-77 years] and the mean duration of their diabetes was 10 years [extreme 0-25 years]. The diabetes was insulin-dependent [type1] in 19 cases and non insulin-dependent [type 2] in 16 cases. Retinopathy and neuropathy were presents in 88% and 83% of the cases respectively. Nephrotic syndrome was secondary to a diabetic nephropathy in 26 cases [74%] and to a non-diabetic nephropathy in 9 cases [26%]. The mean follow-up was 4 years for 22 patients. Evolution was marked by a rapid decline of the renal function in 14 cases [63.6%]. Factors of bad prognosis seem to be the following male sex [11 cases out of 14; 78,5%], type 1 diabetes [10 cases out of 14; 71,4%], poorly controlled hypertension [10 cases on 12; 83,3%], smoking [5 cases out of 14; 35,7%], hyperlipidemia [11 cases out of 14; 78,5%] and nephropathy caused by the diabetic condition [11 cases out of 14; 78,5%]. Control of these risk factors is thus important to prevent the progression of nephrotic syndrome