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However, recent clinical studies have shown that renal insufficiency in the absence of microalbuminuria is relatively common in patients with type 2 diabetes. These results have led to the suggestion that glomerular lesions and arteriosclerosis in the kidney independently play important roles in the development of ESRD in type 2 diabetes.Although small vessel diseases in the kidney may increase the risk of developing impaired renal function, there is still no established method to assess small vessel disease in the kidney.On the other hand, 28 (15.8%) patients in the SCI group and 32 (7.4%) in the non-SCI group were treated with either angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) at baseline.The frequency of patients who were treated with ACE inhibitors or ARBs at baseline was significantly higher in the SCI group than in the non-SCI group.Table 1 compares the baseline clinical characteristics of the study population grouped according to whether the patients had SCI (SCI group, = 431) at baseline.Patients in the SCI group were 6 years older, had diabetes for 2.2 years longer, had higher blood pressure (BP) (systolic BP, 10.3 mm Hg; diastolic BP, 2.8 mm Hg) and higher albumin-to-Cr ratio (ACR) than patients in the non-SCI group.

The frequency of the secondary renal end point of any dialysis and doubling of the serum Cr concentration was also significantly higher in the SCI group than in the non-SCI group (HR, 4.79; 95% CI, 2.72 to 8.46) (Figure 2B, Table 2).The risk for the secondary renal end point of any dialysis or doubling of the serum creatinine concentration was also significantly higher for patients with SCI (hazard ratio, 4.79; 95% CI 2.72 to 8.46).The estimated GFR declined more in patients with SCI than in those without SCI; however, the presence of SCI did not increase the risk for progression of albuminuria.You'll be able to easily handle it in short runs, but you can just as well spend hours thinking about the way to solve the hardest puzzle.This little logic game is usually a grid of 8x8 squares, containing just 1 and 0, and which must be completed according to three simple rules: ✓ There must be an equal number of 0s and 1s in each row and column.

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