Obesity and Renal Prognosis (Assessed by Albuminuria and eGFR) in Type 2 Diabetics in Kinshasa

Background: Obesity is associated with greater survival in end stage renal disease (ESRD). Objective: To assess the association between cardiovascular risk factors and renal Prognosis, assessed by eGFR and albumin/creatinine ratio (ACR), in Congolese Type 2 diabetic patients (T2DM). Methods: Cross-sectional study that included T2DM followed in the University hospital of Kinshasa. ACR and eGFR were used to assess the renal prognosis according to the KDIGO2012 guideline. A Logistic regression model was used to identify independent determinants of renal prognosis. Results: Patients (53 % men, 4.5 % in ESRD) were aged 56 ± 11 years and had a median duration of diabetes of 4 years (IQ: 1-10 years). In the whole group, 40.9 % had a low renal risk prognosis versus 24.9 % a moderately increased risk; 13.3 % a high risk and 21.0 % a very high risk. Diabetes duration ≥ 5 years (aOR: 8.69; p < 0.001), SBP > 130 mmHg (ORa: 15.87; p < 0.001), abdominal obesity (aOR: 0.28; p = 0.036) and HbA1c ≥ 64 mmol/mol (8%)(aOR: 0.13; p < 0.001) emerged as independent determinants of very high renal risk. Conclusions: While obesity in the present study was paradoxically associated with low renal risk, a reverse epidemiology feature, higher SBP and long duration of diabetes emerged as the main determinants of renal prognosis.