Endocrinology and Metabolism

A Ra Jo (Jo AR)

3 Articles

Clinical Study
Prevalent Rate of Nonalbuminuric Renal Insufficiency and Its Association with Cardiovascular Disease Event in Korean Type 2 Diabetes: Hye Won Lee, A Ra Jo, Dong Won Yi, Yang Ho Kang, Seok Man Son; Endocrinol Metab. 2016;31(4):577-585. Published online December 20, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.4.577

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Background

Nonalbuminuric renal insufficiency is a unique category of diabetic kidney diseases. The objectives of the study were to evaluate prevalent rate of nonalbuminuric renal insufficiency and to investigate its relationship with previous cardiovascular disease (CVD) event in Korean patients with type 2 diabetes mellitus (T2DM).

Methods

Laboratory and clinical data of 1,067 subjects with T2DM were obtained and reviewed. Study subjects were allocated into four subgroups according to the CKD classification. Major CVD events were included with coronary, cerebrovascular, and peripheral vascular events.

Results

Nonalbuminuric stage ≥3 CKD group, when compared with albuminuric stage ≥3 CKD group, had shorter diabetic duration, lower concentrations of glycated hemoglobin, high density lipoprotein cholesterol, and high-sensitivity C-reactive protein, lower prevalent rates of retinopathy and previous CVD, and higher rate of treatment with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers. Nonalbuminuric stage ≥3 CKD group showed a greater association with prior CVD events than no CKD group; however, albuminuric stage ≥3 CKD group made addition to increase prevalence of prior CVD events significantly when CKD categories were applied as covariates. Association of prior CVD events, when compared with normal estimated glomerular filtration rate (eGFR) and nonalbuminuria categories, became significant for declined eGFR, which was higher for eGFR of <30 mL/min/1.73 m², and albuminuria.

Conclusion

The results show that subjects with nonalbuminuric stage ≥3 CKD is significantly interrelated with occurrence of prior CVD events than those with normal eGFR with or without albuminuria. Comparing with normal eGFR and nonalbuminuria categories, the combination of increased degree of albuminuria and declined eGFR is becoming significant for the association of prior CVD events.

Citations

Citations to this article as recorded by

Prevalence of normoalbuminuric chronic kidney disease among individuals with type 2 diabetes mellitus from India
Chellamma Jayakumari, Ramesh Gomez, Sasidharan Dipin, R. V. Jayakumar, Karthik Vijayakumar, Ravindranath Sreenath, Thulaseedharan Ajeesh, Puthiyaveettil Khadar Jabbar, Darvin Vamadevan Das, Giri Vishnu Gopi, Thadathil Pandarakandy Seena, Abilash Nair
Indian Journal of Medical Research.2022; 156(4&5): 632. CrossRef
Update on pathogenesis and diagnosis flow of normoalbuminuric diabetes with renal insufficiency
Le Deng, Wenjie Li, Gaosi Xu
European Journal of Medical Research.2021;[Epub] CrossRef
Diabetic kidney disease: new clinical and therapeutic issues. Joint position statement of the Italian Diabetes Society and the Italian Society of Nephrology on “The natural history of diabetic kidney disease and treatment of hyperglycemia in patients with
Giuseppe Pugliese, Giuseppe Penno, Andrea Natali, Federica Barutta, Salvatore Di Paolo, Gianpaolo Reboldi, Loreto Gesualdo, Luca De Nicola
Journal of Nephrology.2020; 33(1): 9. CrossRef
Diabetic kidney disease: New clinical and therapeutic issues. Joint position statement of the Italian Diabetes Society and the Italian Society of Nephrology on “The natural history of diabetic kidney disease and treatment of hyperglycemia in patients with
Giuseppe Pugliese, Giuseppe Penno, Andrea Natali, Federica Barutta, Salvatore Di Paolo, Gianpaolo Reboldi, Loreto Gesualdo, Luca De Nicola
Nutrition, Metabolism and Cardiovascular Diseases.2019; 29(11): 1127. CrossRef
Soluble Dipeptidyl Peptidase-4 Levels Are Associated with Decreased Renal Function in Patients with Type 2 Diabetes Mellitus
Eun-Hee Cho, Sang-Wook Kim
Diabetes & Metabolism Journal.2019; 43(1): 97. CrossRef
STORIA NATURALE DELLA MALATTIA RENALE NEL DIABETE E TRATTAMENTO DELL’IPERGLICEMIA NEI PAZIENTI CON DIABETE DI TIPO 2 E RIDOTTA FUNZIONE RENALE

il Diabete.2019;[Epub] CrossRef
Articles inEndocrinology and Metabolismin 2016
Won-Young Lee
Endocrinology and Metabolism.2017; 32(1): 62. CrossRef
Nonalbuminuric Renal Insufficiency: Can It Be a Novel Category of Diabetic Nephropathy?
Masami Tanaka, Hiroshi Itoh
Endocrinology and Metabolism.2016; 31(4): 533. CrossRef

Ophthalmopathy Induced by Bilateral Carotid Cavernous Fistula in a Patient with Graves' Disease.: Jong Kun Ha, Ji Hye Suk, A Ra Jo, Chan Woo Jung, Bong Jae Kim, Seong Oh Park, Sang Su Kim, Mi Kyung Kim; Endocrinol Metab. 2011;26(4):335-339. Published online December 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.4.335

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Abstract PDF: Graves' disease (GD) can lead to specific eye afflictions including proptosis, periorbital swelling, conjunctival injection, chemosis, and opthalmoplegia, which then become a condition called Graves' ophthalmopathy or thyroid-associated ophthalmopathy (TAO). A carotid cavernous fistula (CCF) is an abnormal vascular communication between the carotid artery and the cavernous sinus. The clinical signs of CCF are very similar to TAO and should be considered as a differential diagnosis of TAO. We would like to present an interesting case of a bilateral ophthalmopathy induced by CCF in a GD patient. A 54-year-old man with a 6-year history of GD presented with bilateral exophthalmos and conjunctival injection for two months. The orbital CT scan findings were consistent with CCF, and an angiography revealed bilateral CCF. He received a bilateral coil embolization for the CCF and his ophthalmic signs were immediately improved. We recommend orbital imaging to exclude other coexisting diseases in patients who are suspected of TAO, especially when the diagnosis is uncertain or when determining whether medical or surgical intervention is appropriate.

A Case of Central Pontine Myelinolysis in a Type 2 Diabetic Patient without Electrolyte Changes.: A Ra Jo, Ji Hye Suk, Jong Kun Ha, Chan Woo Jung, Bong Jae Kim, Seong Oh Park, Seon Chool Hwang, Hyun Wook Choi, Mi Kyung Kim; Endocrinol Metab. 2011;26(3):263-267. Published online September 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.3.263

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Abstract PDF: Central pontine myelinolysis (CPM) by complicating rapid correction of severe hyponatremia has been widely reported. Additionally, CPM was occasionally reported among patients with post-liver transplantation, burns, chronic renal failure with dialysis, or other diseases associated with or not associated with other electrolyte changes or hyperosmolarity. However, there have been a few reports of CPM occurring in diabetic patients without documented electrolyte changes. This report is, to the best of our knowledge, the first report of CPM in type 2 diabetic patients without electrolyte changes in Korea. A 40-year-old man with type 2 diabetes mellitus with abruptly developed dysarthria and ataxia was admitted to our facility. He suffered from poor glucose control and multiple diabetic complications. Brain magnetic resonance imaging (MRI) revealed a well-defined bilateral symmetric hyperintense lesion in the central portion of the pons on T2- and diffusion-weighted images, which was consistent with CPM. After the patient's blood glucose and blood pressure normalized, his dysarthria and ataxia improved. Six months after discharge, follow-up MRI showed a persistent, but greatly reduced symmetric lesion in the central pons. It is certainly possible for CPM to be overlooked clinically in diabetic patients, but more cases could be diagnosed if careful attention was paid to this syndrome.

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