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.