AIMS/HYPOTHESIS: In type 2 diabetic patients at low risk for cardiovascular disease (CVD), the relationship between the clinical course of nephropathy by stage of chronic kidney disease (CKD) and onset of CVD remains unclear. Clarification of this relationship is important for clinical decision-making for both low- and high-risk diabetic patients. METHODS: This 4 year prospective study enrolled 2,954 type 2 diabetic patients with no prevalent CVD, and serum creatinine <176.8 μmol/l. The risk for CVD onset (non-fatal and fatal CVD and stroke, and peripheral arterial disease) was assessed according to CKD stage categorised by urinary albumin-to-creatinine ratio (ACR; mg/mmol) and estimated GFR (eGFR; ml min(-1) 1.73 m(-2)). Association of progression from 'no CKD' stage (ACR <3.5 mg/mmol and eGFR ≥ 90 ml min(-1) 1.73 m(-2)) with risk for CVD onset was also evaluated. RESULTS: During follow-up (median 3.8 years), 89 CVD events occurred. Compared with patients with 'no CKD' as reference, those with ACR ≥ 35.0 mg/mmol with co-existing eGFR 60-89 ml min(-1) 1.73 m(-2) or <60 ml min(-1) 1.73 m(-2) showed increased risk for CVD onset, whereas those with eGFR ≥ 90 ml min(-1) 1.73 m(-2) did not. Those with ACR <3.5 mg/mmol and eGFR <60 ml min(-1) 1.73 m(-2) did not show any increased risk. Among patients with 'no CKD' stage at baseline, those who progressed to ACR ≥ 3.5 mg/mmol during follow-up showed an increased risk compared with those who did not, whereas those who progressed to eGFR <90 ml min(-1) 1.73 m(-2) did not have increased risk. CONCLUSIONS/ INTERPRETATION: The risk for CVD was associated with progression of albuminuria stage rather than eGFR stage in type 2 diabetic patients at relatively low risk for CVD.
AIMS/HYPOTHESIS: In type 2 diabeticpatients at low risk for cardiovascular disease (CVD), the relationship between the clinical course of nephropathy by stage of chronic kidney disease (CKD) and onset of CVD remains unclear. Clarification of this relationship is important for clinical decision-making for both low- and high-risk diabeticpatients. METHODS: This 4 year prospective study enrolled 2,954 type 2 diabeticpatients with no prevalent CVD, and serum creatinine <176.8 μmol/l. The risk for CVD onset (non-fatal and fatal CVD and stroke, and peripheral arterial disease) was assessed according to CKD stage categorised by urinary albumin-to-creatinine ratio (ACR; mg/mmol) and estimated GFR (eGFR; ml min(-1) 1.73 m(-2)). Association of progression from 'no CKD' stage (ACR <3.5 mg/mmol and eGFR ≥ 90 ml min(-1) 1.73 m(-2)) with risk for CVD onset was also evaluated. RESULTS: During follow-up (median 3.8 years), 89 CVD events occurred. Compared with patients with 'no CKD' as reference, those with ACR ≥ 35.0 mg/mmol with co-existing eGFR 60-89 ml min(-1) 1.73 m(-2) or <60 ml min(-1) 1.73 m(-2) showed increased risk for CVD onset, whereas those with eGFR ≥ 90 ml min(-1) 1.73 m(-2) did not. Those with ACR <3.5 mg/mmol and eGFR <60 ml min(-1) 1.73 m(-2) did not show any increased risk. Among patients with 'no CKD' stage at baseline, those who progressed to ACR ≥ 3.5 mg/mmol during follow-up showed an increased risk compared with those who did not, whereas those who progressed to eGFR <90 ml min(-1) 1.73 m(-2) did not have increased risk. CONCLUSIONS/ INTERPRETATION: The risk for CVD was associated with progression of albuminuria stage rather than eGFR stage in type 2 diabeticpatients at relatively low risk for CVD.
Authors: Roland E Schmieder; Johannes F E Mann; Helmut Schumacher; Peggy Gao; Giuseppe Mancia; Michael A Weber; Matthew McQueen; Teo Koon; Salim Yusuf Journal: J Am Soc Nephrol Date: 2011-06-30 Impact factor: 10.121
Authors: H Yokoyama; M Matsushima; K Kawai; K Hirao; M Oishi; H Sugimoto; H Takeda; M Minami; M Kobayashi; H Sone Journal: Diabet Med Date: 2011-10 Impact factor: 4.359
Authors: Andrew S Levey; Paul E de Jong; Josef Coresh; Meguid El Nahas; Brad C Astor; Kunihiro Matsushita; Ron T Gansevoort; Bertram L Kasiske; Kai-Uwe Eckardt Journal: Kidney Int Date: 2010-12-08 Impact factor: 10.612
Authors: G Bruno; F Merletti; G Bargero; G Novelli; D Melis; A Soddu; M Perotto; G Pagano; P Cavallo-Perin Journal: Diabetologia Date: 2007-03-02 Impact factor: 10.122
Authors: Bastiaan E de Galan; Vlado Perkovic; Toshiharu Ninomiya; Avinesh Pillai; Anushka Patel; Alan Cass; Bruce Neal; Neil Poulter; Stephen Harrap; Carl-Erik Mogensen; Mark Cooper; Michel Marre; Bryan Williams; Pavel Hamet; Giuseppe Mancia; Mark Woodward; Paul Glasziou; Diederick E Grobbee; Stephen MacMahon; John Chalmers Journal: J Am Soc Nephrol Date: 2009-02-18 Impact factor: 10.121
Authors: Helen L Lutgers; Esther G Gerrits; Wim J Sluiter; Lielith J Ubink-Veltmaat; Gijs W D Landman; Thera P Links; Reinold O B Gans; Andries J Smit; Henk J G Bilo Journal: PLoS One Date: 2009-08-28 Impact factor: 3.240
Authors: Lucia Cea Soriano; Saga Johansson; Bergur Stefansson; Luis A García Rodríguez Journal: Cardiovasc Diabetol Date: 2015-04-18 Impact factor: 9.951