http://www.revistadechimie.ro REV.CHIM.(Bucharest) ♦69♦No.8♦2018 2064 *email: adrian.apostol@neurotim.ro; Phone: + 40 740 987 464 New Considerations Regarding Chronic Kidney Disease, Cardiovascular Disease and Dyslipidemia in Diabetic Patients MIRCEA MUNTEANU 1 , ADRIAN APOSTOL 2 *, VIVIANA IVAN 2 1 Victor Babes University of Medicine and Pharmacy, Department of Internal Medicine II - Clinic of Diabetes, Nutrition and Metabolic Disorders, 2 Eftimie Murgu Sq., 300041, Timisoara, Romania 2 Victor Babes University of Medicine and Pharmacy, Department of Cardiology - 2 nd Cardiology Clinic, 2 Eftimie Murgu Sq., 300041, Timisoara, Romania The aim of the present study is to investigate the prevalance of chronic kidney disease (CKD), of cardiovascular disease (CVD) and dyslipidemia in patients with diabetes mellitus (DM). We conducted a prospective, controlled study involving 420 diabetic patients (120 T1DM, 300 T2DM) and investigate the following aspects: the presence of vascular complications (stroke, coronary artery disease, peripheral artery disease), lipid profile (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides), kidney function (glomerular filtration rate, albuminuria), blood pressure, HbA1C. The results that in diabetic patients with CKD there is an increased prevalence of CVD and of dislipidemia. Also we noticed a negative correlation between total cholesterol level and decease in eGFR in all patients, with or without CKD. Keywords: diabetes mellitus, chronic kidney disease, cardiovascular disease, dyslipidemia Diabetes mellitus (DM) it is a major problem of health all over the world – it is a problem affecting millions of persons especially by the micro and macrovascular complications strongly related to the increased oxidative stress generated at the vascular level [1-6]. In the context of DM, one of the most complication is the chronic impairment of the kidney function-chronic kidney disease (CKD)[7, 8]. The prevalence of CKD in diabetic patients (named diabetic kidney disease - DKD) has an increased prevalence all over the word. Is characterized by high urine albumin excretion and reduction of glomerular flitration rate (eGFR), accompanied by the elevation of arterial blood pressure. In the evolution process of DKD almost 50 % of diabetic patients will present microalbuminuria (30-300 mg/day, moderate albuminuria) and around 30% will develov proteinuria (> 300 mg/day, severe albuminuria) being at increased risk to develop end-stage-renal-disease (ESRD)[8, 9]. In the same time, patients with DKD have higher risk to develop the vascular complication of DM[10- 12]. Classicaly, the risk of CVD become increased as albuminuria increases and eGFR decreases. The factors responsible for the negative evolution of DKD are: poor glycemic control, high blood pressure, albuminuria level [13-15]. In the evolution of DKD the most severe complication it is represented by the renal failure. The evolution time necessarily to develop renal failure from the apparition of moderate albuminuria is around 9 years. In conditions of optimal glycemic and blood pressure control this time duration can be doubled [16-18]. In US CKD is present in 40% of patients with type 2 DM (Fourth National Health and Nutrition Examination Survey). There is a powerfull correlation between renal and cardiac pathophysiology in type 2 diabetes, this aspect being expressed by the cardio-renal risk factors: type 2 DM, obesity, smoking, dyslipidemia, hypertension, genetic factors, etc. Regarding the association between DM with dyslipidemia and hypertension, approximately 50% of people with DM present simultaneously both dyslipidemia and hypertension [8, 9, 19]. The aim of this study is to investigate the prevalance of CKD, CVD and dyslipidemia in patients with DM from an outpatient diabetes survey unit from western Romania. Experimental part Material and methods In this study were included 420 diabetic patients, 120 with type 1 and 300 with type 2. The characteristics of the groups are presented in table 1. Clinical and paraclinical investigations Based on estimate glomerular filtration rate (eGFR) patients were divided in two groups: with and without chronic kidney disease (CKD). Diagnosis of CKD was established using K/DOQI criteria (2002). Estimated glomerular filtration rate (eGFR) was calculated with MDRD 4 (Modification of Diet in Renal Disease) formula. In all the patients we investigate the following parameters: Table 1 CHARACTERISTICS OF THE GROUPS