In:
BMJ Open Diabetes Research & Care, BMJ, Vol. 9, No. 1 ( 2021-06), p. e002311-
Kurzfassung:
Changes in albuminuria or estimated glomerular filtration rate (eGFR) can be used as a surrogate endpoint of end-stage kidney disease (ESKD) in people with type 2 diabetes. We investigated whether the combined changes in albuminuria and eGFR are more strongly associated with future risk of ESKD. Research design and methods Using data from a multicenter observational cohort study of people with type 2 diabetes, we evaluated the association of percentage change in urine albumin to creatinine ratio (UACR) and/or annual change in eGFR over 2 years with subsequent ESKD risk. Results Among 1417 patients with repeated albuminuria and eGFR over 2 years, 129 (9.1%) developed ESKD. Patients with 〉 30% UACR decline had lower ESKD risk (HR 0.47; 95% CI 0.29 to 0.77), whereas those with 〉 30% UACR increase had higher ESKD risk (HR 2.31; 95% CI 1.52 to 3.51), compared with those with minor UACR change. Patients with greater eGFR decline had an increased ESKD risk than those with minor eGFR change (a decline of 〈 2.5 mL/min/1.73 m 2 /year): HR 4.19 (95% CI 1.87 to 9.38) and 2.89 (95% CI 1.32 to 6.33) for those with a decline of 〉 5 and 2.5–5 mL/min/1.73 m 2 /year, respectively. When the combined changes in UACR and eGFR were used, the highest ESKD risk (HR 5.60; 95% CI 2.08 to 15.09) was observed among patients with 〉 30% UACR increase and an eGFR decline of 〉 5 mL/min/1.73 m 2 /year compared with those with a minor change in UACR and eGFR. Conclusions Combined changes in albuminuria and eGFR over 2 years were strongly associated with future risk of kidney failure in patients with type 2 diabetes.
Materialart:
Online-Ressource
ISSN:
2052-4897
DOI:
10.1136/bmjdrc-2021-002311
Sprache:
Englisch
Verlag:
BMJ
Publikationsdatum:
2021
ZDB Id:
2732918-5