Association of kidney disease measures with risk of renal function worsening in patients with hypertension and type 2 diabetes

Francesca Viazzi, Pamela Piscitelli, Carlo Giorda, Antonio Ceriello, Stefano Genovese, Giuseppina T. Russo, Paola Fioretto, Pietro Guida, Salvatore De Cosmo, Roberto Pontremoli

Research output: Contribution to journalArticlepeer-review

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 5. mL reduction (below 90. mL/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.

Original languageEnglish
JournalJournal of Diabetes and its Complications
DOIs
Publication statusAccepted/In press - Sep 1 2016

Keywords

  • Albuminuria
  • Chronic kidney disease
  • Glomerular filtration rate
  • Risk factors
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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