Miguel Bigotte Vieira1, João Sérgio Neves2,3, Lia Leitão4, Rute Baeta Baptista5,6, Rita Magriço7, Catarina Viegas Dias8, Ana Oliveira2, Davide Carvalho2,9, Finnian R Mc Causland10,11. 1. Nephrology and Renal Transplantation Department, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal. 2. Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Faculdade de Medicina, Universidade do Porto, Porto, Portugal. 3. Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Porto, Portugal. 4. Neurology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal. 5. Pediatrics Department, Hospital de Dona Estefânia, Centro Hospitalar Universitário Lisboa Central, Portugal. 6. Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal. 7. Serviço de Nefrologia, Hospital Curry Cabral, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal. 8. NOVA Medical School, Lisboa, Portugal. 9. Instituto de Investigação e Inovação em Saúde da Universidade do Porto, Portugal. 10. Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. 11. Harvard Medical School, Boston, Massachusetts, USA.
Abstract
PURPOSE: Diabetes mellitus is a risk factor for the development and progression of chronic kidney disease (CKD). However, the association of prediabetes with adverse kidney outcomes is uncertain. METHODS: We performed a secondary analysis of the Systolic Blood Pressure Intervention Trial (SPRINT), including 9,361 participants without diabetes at baseline. We categorized participants according to fasting glucose as having impaired fasting glucose (≥100 mg/dL [(≥5.6 mmol/L]) or normoglycemia (<100 mg/dL [(<5.6 mmol/L]). Unadjusted and adjusted proportional hazards models were fit to estimate the association of impaired fasting glucose (versus normoglycemia) with a composite outcome of worsening kidney function (≥30% decrease in eGFR to <60 ml/min/1.73 m2 in participants without baseline CKD; ≥50% decrease in eGFR or need of long-term dialysis/kidney transplantation in participants with CKD) or incident albuminuria (doubling of urinary albumin to creatinine ratio from <10 mg/g to >10 mg/g). These outcomes were also evaluated separately, and according to CKD status at baseline. RESULTS: The mean age was 67.9 ± 9.4 years, 35.5% were female, and 31.4% were black. The median follow-up was 3.3 years and 41.8% had impaired fasting glucose. Impaired fasting glucose was not associated with higher rates of the composite outcome (HR 0.97; 95%CI 0.81-1.16), worsening kidney function (HR 1.02; 95%CI 0.75-1.37), or albuminuria (HR 0.98; 95%CI 0.78-1.23). Similarly, there was no association of impaired fasting glucose with outcomes according to baseline CKD status. CONCLUSIONS: Impaired fasting glucose at baseline was not associated with the development of worsening kidney function or albuminuria in participants of SPRINT.
PURPOSE:Diabetes mellitus is a risk factor for the development and progression of chronic kidney disease (CKD). However, the association of prediabetes with adverse kidney outcomes is uncertain. METHODS: We performed a secondary analysis of the Systolic Blood Pressure Intervention Trial (SPRINT), including 9,361 participants without diabetes at baseline. We categorized participants according to fasting glucose as having impaired fasting glucose (≥100 mg/dL [(≥5.6 mmol/L]) or normoglycemia (<100 mg/dL [(<5.6 mmol/L]). Unadjusted and adjusted proportional hazards models were fit to estimate the association of impaired fasting glucose (versus normoglycemia) with a composite outcome of worsening kidney function (≥30% decrease in eGFR to <60 ml/min/1.73 m2 in participants without baseline CKD; ≥50% decrease in eGFR or need of long-term dialysis/kidney transplantation in participants with CKD) or incident albuminuria (doubling of urinary albumin to creatinine ratio from <10 mg/g to >10 mg/g). These outcomes were also evaluated separately, and according to CKD status at baseline. RESULTS: The mean age was 67.9 ± 9.4 years, 35.5% were female, and 31.4% were black. The median follow-up was 3.3 years and 41.8% had impaired fasting glucose. Impaired fasting glucose was not associated with higher rates of the composite outcome (HR 0.97; 95%CI 0.81-1.16), worsening kidney function (HR 1.02; 95%CI 0.75-1.37), or albuminuria (HR 0.98; 95%CI 0.78-1.23). Similarly, there was no association of impaired fasting glucose with outcomes according to baseline CKD status. CONCLUSIONS: Impaired fasting glucose at baseline was not associated with the development of worsening kidney function or albuminuria in participants of SPRINT.
Authors: M M Gabir; R L Hanson; D Dabelea; G Imperatore; J Roumain; P H Bennett; W C Knowler Journal: Diabetes Care Date: 2000-08 Impact factor: 19.112
Authors: Laura C Plantinga; Deidra C Crews; Josef Coresh; Edgar R Miller; Rajiv Saran; Jerry Yee; Elizabeth Hedgeman; Meda Pavkov; Mark S Eberhardt; Desmond E Williams; Neil R Powe Journal: Clin J Am Soc Nephrol Date: 2010-03-25 Impact factor: 8.237
Authors: Alan J Garber; Yehuda Handelsman; Daniel Einhorn; Donald A Bergman; Zachary T Bloomgarden; Vivian Fonseca; W Timothy Garvey; James R Gavin; George Grunberger; Edward S Horton; Paul S Jellinger; Kenneth L Jones; Harold Lebovitz; Philip Levy; Darren K McGuire; Etie S Moghissi; Richard W Nesto Journal: Endocr Pract Date: 2008-10 Impact factor: 3.443
Authors: Caroline S Fox; Martin G Larson; Eric P Leip; James B Meigs; Peter W F Wilson; Daniel Levy Journal: Diabetes Care Date: 2005-10 Impact factor: 19.112
Authors: Christine M Hoehner; Kurt J Greenlund; Stephen Rith-Najarian; Michele L Casper; William M McClellan Journal: J Am Soc Nephrol Date: 2002-06 Impact factor: 10.121
Authors: N Sarwar; P Gao; S R Kondapally Seshasai; R Gobin; S Kaptoge; E Di Angelantonio; E Ingelsson; D A Lawlor; E Selvin; M Stampfer; C D A Stehouwer; S Lewington; L Pennells; A Thompson; N Sattar; I R White; K K Ray; J Danesh Journal: Lancet Date: 2010-06-26 Impact factor: 202.731
Authors: Alexander Thompson; Emanuele Di Angelantonio; Pei Gao; Nadeem Sarwar; Sreenivasa Rao Kondapally Seshasai; Stephen Kaptoge; Peter H Whincup; Kenneth J Mukamal; Richard F Gillum; Ingar Holme; Inger Njølstad; Astrid Fletcher; Peter Nilsson; Sarah Lewington; Rory Collins; Vilmundur Gudnason; Simon G Thompson; Naveed Sattar; Elizabeth Selvin; Frank B Hu; John Danesh Journal: N Engl J Med Date: 2011-03-03 Impact factor: 91.245
Authors: Toralf Melsom; Ulla Dorte Mathisen; Ole C Ingebretsen; Trond G Jenssen; Inger Njølstad; Marit D Solbu; Ingrid Toft; Bjørn O Eriksen Journal: Diabetes Care Date: 2011-05-18 Impact factor: 19.112
Authors: João Sérgio Neves; Simon Correa; Rute Baeta Baptista; Miguel Bigotte Vieira; Sushrut S Waikar; Finnian R Mc Causland Journal: J Clin Endocrinol Metab Date: 2020-04-01 Impact factor: 5.958
Authors: Sun H Kim; Irwin G Brodsky; Ranee Chatterjee; Sangeeta R Kashyap; William C Knowler; Emilia Liao; Jason Nelson; Richard Pratley; Neda Rasouli; Ellen M Vickery; Mark Sarnak; Anastassios G Pittas Journal: Clin J Am Soc Nephrol Date: 2021-08 Impact factor: 10.614
Authors: Wei Li; Anping Wang; Jiajia Jiang; Guangxu Liu; Meiping Wang; Dongxue Li; Jing Wen; Yiming Mu; Xiaoyan Du; Herbert Gaisano; Jingtao Dou; Yan He Journal: BMJ Open Diabetes Res Care Date: 2020-04