Francesca Viazzi1, Pamela Piscitelli2, Carlo Giorda3, Antonio Ceriello4, Stefano Genovese5, Giuseppina T Russo6, Paola Fioretto7, Pietro Guida8, Salvatore De Cosmo2, Roberto Pontremoli9. 1. Università degli Studi and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genova, Italy. Electronic address: francesca.viazzi@unige.it. 2. Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy. 3. Diabetes and Metabolism Unit ASL Turin 5 Chieri (TO), Italy. 4. Institut d'Investigacions Biomèdiques August Pii Sunyer (IDIBAPS) and Centro de Investigación Biomédicaen Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain; Department of Cardiovascular and Metabolic Diseases, IRCCS Gruppo Multimedica, Sesto San Giovanni, Milano, Italy. 5. Department of Cardiovascular and Metabolic Diseases, IRCCS Gruppo Multimedica, Sesto San Giovanni, Milano, Italy. 6. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy. 7. Department of Medicine, University of Padua, Padua, Italy. 8. Associazione Medici Diabetologi, Rome, Italy. 9. Università degli Studi and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genova, Italy.
Abstract
AIMS: To assess the role of kidney disease measures on the development of chronic kidney disease (CKD) in patients with type 2 diabetes (T2D) and hypertension (HT). METHODS: Clinical records from a total of 17,160 patients with T2D and HT, a baseline estimated glomerular filtration rate (eGFR) values ≥60mL/min/1.73m2, evaluation for albuminuria and regular visits during a four-year follow-up were retrieved and analyzed. The incidence of eGFR <60mL/min/1.73m2 and/or a reduction >30% from baseline was evaluated. RESULTS: At baseline 23% of patients (n=3873) had albuminuria. Over the 4-year follow-up 20% (n=3480) developed a renal endpoint 28% (n=1074) of those with albuminuria and 17% (n=2406) of those without albuminuria. The presence of baseline albuminuria entailed a 1.8 independent, greater risk of reaching stage 3 CKD. Patients with normal albuminuria showed a 1.54 (p<0.001) greater risk for each 5mL reduction (below 90mL/min) in baseline GFR. CONCLUSIONS: In T2D patients with HT, eGFR reduction and albuminuria are independently associated with a greater risk of developing stage 3 CKD. While baseline albuminuria entails a greater renal risk, due to a larger occurrence of the non-albuminuric phenotype, renal function worsening is more likely to be observed in patients without albuminuria.
AIMS: To assess the role of kidney disease measures on the development of chronic kidney disease (CKD) in patients with type 2 diabetes (T2D) and hypertension (HT). METHODS: Clinical records from a total of 17,160 patients with T2D and HT, a baseline estimated glomerular filtration rate (eGFR) values ≥60mL/min/1.73m2, evaluation for albuminuria and regular visits during a four-year follow-up were retrieved and analyzed. The incidence of eGFR <60mL/min/1.73m2 and/or a reduction >30% from baseline was evaluated. RESULTS: At baseline 23% of patients (n=3873) had albuminuria. Over the 4-year follow-up 20% (n=3480) developed a renal endpoint 28% (n=1074) of those with albuminuria and 17% (n=2406) of those without albuminuria. The presence of baseline albuminuria entailed a 1.8 independent, greater risk of reaching stage 3 CKD. Patients with normal albuminuria showed a 1.54 (p<0.001) greater risk for each 5mL reduction (below 90mL/min) in baseline GFR. CONCLUSIONS: In T2D patients with HT, eGFR reduction and albuminuria are independently associated with a greater risk of developing stage 3 CKD. While baseline albuminuria entails a greater renal risk, due to a larger occurrence of the non-albuminuric phenotype, renal function worsening is more likely to be observed in patients without albuminuria.
Authors: Susana Hong; Lubaina Presswala; Yael T Harris; Isabela Romao; Daniel W Ross; Hugo Andrade Paz; Meng Zhang; Kenar D Jhaveri; Vipul Sakhiya; Steven Fishbane Journal: Kidney360 Date: 2020-07-09
Authors: Antonio Mirijello; Francesca Viazzi; Paola Fioretto; Carlo Giorda; Antonio Ceriello; Giuspina T Russo; Pietro Guida; Roberto Pontremoli; Salvatore De Cosmo Journal: BMC Nephrol Date: 2018-12-04 Impact factor: 2.388