The association between estimated glomerular filtration rate, albuminuria, and risk of cardiovascular hospitalizations and all-cause mortality among patients with type 2 diabetes
We evaluated the simultaneous effects of all clinically recognized categories of albuminuria and estimated glomerular filtration rate (eGFR) on cardiovascular disease (CVD) and mortality We conducted a longitudinal observational study of 16,678 type 2 diabetes (T2D) patients. From the first serum cr...
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| Veröffentlicht in: | Journal of diabetes and its complications 2018-03, Vol.32 (3), p.291-297 |
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| creator | Nichols, Gregory A. Déruaz-Luyet, Anouk Hauske, Sibylle J. Brodovicz, Kimberly G. |
| description | We evaluated the simultaneous effects of all clinically recognized categories of albuminuria and estimated glomerular filtration rate (eGFR) on cardiovascular disease (CVD) and mortality
We conducted a longitudinal observational study of 16,678 type 2 diabetes (T2D) patients. From the first serum creatinine value from 2006 to 2012 and a urine-albumin creatinine ratio (UACR) recorded within 6months, we applied baseline Kidney Disease: Improving Global Outcomes (KDIGO) categories of eGFR and albuminuria. We followed patients for up to 11years to calculate adjusted incidence per 1000person-years (p-y) of first CVD hospitalization and all-cause mortality.
Over 98,069p-y of follow-up, CVD hospitalization risk was greater for each higher eGFR and albuminuria category. In eGFR category G2 (60-89mL/min/1.73m2), adjusted incidence per 1000p-y was 14.1 (95% CI 12.9-15.5), 19.8 (17.2-22.8), and 22.8 (17.4-30.0) for normoalbuminuria, microalbuminuria and macroalbuminuria, respectively. For eGFR category G3a (45-59), rates were 26.7 (22.3-32.0), 40.3 (32.2-50.5), and 44.1 (28.8-67.4), respectively. Adjusted risk of all-cause mortality followed a similar pattern.
Our data underscore the importance of including detailed eGFR and UACR values in assessing CVD risk. High albuminuria and low eGFR is a potent predictor of CVD and death. |
| doi_str_mv | 10.1016/j.jdiacomp.2017.12.003 |
| format | Article |
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We conducted a longitudinal observational study of 16,678 type 2 diabetes (T2D) patients. From the first serum creatinine value from 2006 to 2012 and a urine-albumin creatinine ratio (UACR) recorded within 6months, we applied baseline Kidney Disease: Improving Global Outcomes (KDIGO) categories of eGFR and albuminuria. We followed patients for up to 11years to calculate adjusted incidence per 1000person-years (p-y) of first CVD hospitalization and all-cause mortality.
Over 98,069p-y of follow-up, CVD hospitalization risk was greater for each higher eGFR and albuminuria category. In eGFR category G2 (60-89mL/min/1.73m2), adjusted incidence per 1000p-y was 14.1 (95% CI 12.9-15.5), 19.8 (17.2-22.8), and 22.8 (17.4-30.0) for normoalbuminuria, microalbuminuria and macroalbuminuria, respectively. For eGFR category G3a (45-59), rates were 26.7 (22.3-32.0), 40.3 (32.2-50.5), and 44.1 (28.8-67.4), respectively. Adjusted risk of all-cause mortality followed a similar pattern.
Our data underscore the importance of including detailed eGFR and UACR values in assessing CVD risk. High albuminuria and low eGFR is a potent predictor of CVD and death.</description><identifier>ISSN: 1056-8727</identifier><identifier>EISSN: 1873-460X</identifier><identifier>DOI: 10.1016/j.jdiacomp.2017.12.003</identifier><identifier>PMID: 29352693</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Albuminuria ; Albuminuria - complications ; Cardiovascular disease ; Cardiovascular Diseases - epidemiology ; Creatinine - metabolism ; Diabetes ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - metabolism ; Diabetes Mellitus, Type 2 - mortality ; Diabetic Angiopathies - epidemiology ; Diabetic kidney disease ; eGFR ; Female ; Generalized linear models ; Glomerular Filtration Rate ; Health risk assessment ; Heart failure ; Hospitalization ; Humans ; Incidence ; Kidney diseases ; Laboratories ; Longitudinal Studies ; Male ; Middle Aged ; Mortality ; Survival Rate</subject><ispartof>Journal of diabetes and its complications, 2018-03, Vol.32 (3), p.291-297</ispartof><rights>2017</rights><rights>Copyright © 2017. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Mar 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-84e2731d573784184043b50093446d7e46e4c7dc68536a2fb2ab3f91587bd96f3</citedby><cites>FETCH-LOGICAL-c396t-84e2731d573784184043b50093446d7e46e4c7dc68536a2fb2ab3f91587bd96f3</cites><orcidid>0000-0002-7563-6236</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2019867514?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29352693$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nichols, Gregory A.</creatorcontrib><creatorcontrib>Déruaz-Luyet, Anouk</creatorcontrib><creatorcontrib>Hauske, Sibylle J.</creatorcontrib><creatorcontrib>Brodovicz, Kimberly G.</creatorcontrib><title>The association between estimated glomerular filtration rate, albuminuria, and risk of cardiovascular hospitalizations and all-cause mortality among patients with type 2 diabetes</title><title>Journal of diabetes and its complications</title><addtitle>J Diabetes Complications</addtitle><description>We evaluated the simultaneous effects of all clinically recognized categories of albuminuria and estimated glomerular filtration rate (eGFR) on cardiovascular disease (CVD) and mortality
We conducted a longitudinal observational study of 16,678 type 2 diabetes (T2D) patients. From the first serum creatinine value from 2006 to 2012 and a urine-albumin creatinine ratio (UACR) recorded within 6months, we applied baseline Kidney Disease: Improving Global Outcomes (KDIGO) categories of eGFR and albuminuria. We followed patients for up to 11years to calculate adjusted incidence per 1000person-years (p-y) of first CVD hospitalization and all-cause mortality.
Over 98,069p-y of follow-up, CVD hospitalization risk was greater for each higher eGFR and albuminuria category. In eGFR category G2 (60-89mL/min/1.73m2), adjusted incidence per 1000p-y was 14.1 (95% CI 12.9-15.5), 19.8 (17.2-22.8), and 22.8 (17.4-30.0) for normoalbuminuria, microalbuminuria and macroalbuminuria, respectively. For eGFR category G3a (45-59), rates were 26.7 (22.3-32.0), 40.3 (32.2-50.5), and 44.1 (28.8-67.4), respectively. Adjusted risk of all-cause mortality followed a similar pattern.
Our data underscore the importance of including detailed eGFR and UACR values in assessing CVD risk. High albuminuria and low eGFR is a potent predictor of CVD and death.</description><subject>Aged</subject><subject>Albuminuria</subject><subject>Albuminuria - complications</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Creatinine - metabolism</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - metabolism</subject><subject>Diabetes Mellitus, Type 2 - mortality</subject><subject>Diabetic Angiopathies - epidemiology</subject><subject>Diabetic kidney disease</subject><subject>eGFR</subject><subject>Female</subject><subject>Generalized linear models</subject><subject>Glomerular Filtration Rate</subject><subject>Health risk assessment</subject><subject>Heart failure</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kidney diseases</subject><subject>Laboratories</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Survival Rate</subject><issn>1056-8727</issn><issn>1873-460X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkcFu1DAQhiMEoqXwCpUlLhxIsGPHjm-gqhSkSlyKxM1y7EnXixMH22m1PBZPWO9uy4ELp7Hl758Z_39VnRPcEEz4h22ztU6bMC1Ni4loSNtgTJ9Vp6QXtGYc_3hezrjjdS9acVK9SmmLMeZdR15WJ62kXcslPa3-3GwA6ZSCcTq7MKMB8j3AjCBlN-kMFt36MEFcvY5odD7HI1cKvEfaD-vk5jU6XS6zRdGlnyiMyOhoXbjTyRyEm5AWl7V3vw_qdGC197XRawI0hbh_zDukpzDfoqVQMOeE7l3eoLxbALWo_LcsB-l19WLUPsGbx3pWff98eXPxpb7-dvX14tN1bajkue4ZtIIS2wkqekZ6hhkdOowlZYxbAYwDM8Ia3neU63YcWj3QUZKuF4OVfKRn1btj3yWGX2vxQ00uGfBezxDWpIjsJcdS9rigb_9Bt2GNc9lOlXRkz0VHWKH4kTIxpBRhVEssHsedIljtU1Vb9ZTqXicUaVVJtQjPH9uvwwT2r-wpxgJ8PAJQ_LhzEFUyxUAD1kUwWdng_jfjAVFUul0</recordid><startdate>201803</startdate><enddate>201803</enddate><creator>Nichols, Gregory A.</creator><creator>Déruaz-Luyet, Anouk</creator><creator>Hauske, Sibylle J.</creator><creator>Brodovicz, Kimberly G.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7563-6236</orcidid></search><sort><creationdate>201803</creationdate><title>The association between estimated glomerular filtration rate, albuminuria, and risk of cardiovascular hospitalizations and all-cause mortality among patients with type 2 diabetes</title><author>Nichols, Gregory A. ; 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We conducted a longitudinal observational study of 16,678 type 2 diabetes (T2D) patients. From the first serum creatinine value from 2006 to 2012 and a urine-albumin creatinine ratio (UACR) recorded within 6months, we applied baseline Kidney Disease: Improving Global Outcomes (KDIGO) categories of eGFR and albuminuria. We followed patients for up to 11years to calculate adjusted incidence per 1000person-years (p-y) of first CVD hospitalization and all-cause mortality.
Over 98,069p-y of follow-up, CVD hospitalization risk was greater for each higher eGFR and albuminuria category. In eGFR category G2 (60-89mL/min/1.73m2), adjusted incidence per 1000p-y was 14.1 (95% CI 12.9-15.5), 19.8 (17.2-22.8), and 22.8 (17.4-30.0) for normoalbuminuria, microalbuminuria and macroalbuminuria, respectively. For eGFR category G3a (45-59), rates were 26.7 (22.3-32.0), 40.3 (32.2-50.5), and 44.1 (28.8-67.4), respectively. Adjusted risk of all-cause mortality followed a similar pattern.
Our data underscore the importance of including detailed eGFR and UACR values in assessing CVD risk. High albuminuria and low eGFR is a potent predictor of CVD and death.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29352693</pmid><doi>10.1016/j.jdiacomp.2017.12.003</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7563-6236</orcidid></addata></record> |
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| subjects | Aged Albuminuria Albuminuria - complications Cardiovascular disease Cardiovascular Diseases - epidemiology Creatinine - metabolism Diabetes Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - metabolism Diabetes Mellitus, Type 2 - mortality Diabetic Angiopathies - epidemiology Diabetic kidney disease eGFR Female Generalized linear models Glomerular Filtration Rate Health risk assessment Heart failure Hospitalization Humans Incidence Kidney diseases Laboratories Longitudinal Studies Male Middle Aged Mortality Survival Rate |
| title | The association between estimated glomerular filtration rate, albuminuria, and risk of cardiovascular hospitalizations and all-cause mortality among patients with type 2 diabetes |
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