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

Francesca Viazzi, Angela Pamela Piscitelli, Carlo Giorda, Antonio Ceriello, Stefano Genovese, Giuseppina T Russo, Paola Fioretto, Pietro Guida, Salvatore De Cosmo, Roberto Pontremoli, AMD-Annals Study Group

Research output: Contribution to journalArticle

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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/1.73m(2), evaluation for albuminuria and regular visits during a four-year follow-up were retrieved and analyzed. The incidence of eGFR <60mL/min/1.73m(2) 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.

Original languageEnglish
Pages (from-to)419-426
Number of pages8
JournalJournal of Diabetes and its Complications
Volume31
Issue number2
DOIs
Publication statusPublished - Feb 2017

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Albuminuria
Kidney Diseases
Type 2 Diabetes Mellitus
Hypertension
Kidney
Glomerular Filtration Rate
Chronic Renal Insufficiency
Phenotype
Incidence

Keywords

  • Journal Article

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Association of kidney disease measures with risk of renal function worsening in patients with hypertension and type 2 diabetes. / Viazzi, Francesca; Piscitelli, Angela Pamela; Giorda, Carlo; Ceriello, Antonio; Genovese, Stefano; Russo, Giuseppina T; Fioretto, Paola; Guida, Pietro; De Cosmo, Salvatore; Pontremoli, Roberto; AMD-Annals Study Group.

In: Journal of Diabetes and its Complications, Vol. 31, No. 2, 02.2017, p. 419-426.

Research output: Contribution to journalArticle

Viazzi, Francesca ; Piscitelli, Angela Pamela ; Giorda, Carlo ; Ceriello, Antonio ; Genovese, Stefano ; Russo, Giuseppina T ; Fioretto, Paola ; Guida, Pietro ; De Cosmo, Salvatore ; Pontremoli, Roberto ; AMD-Annals Study Group. / Association of kidney disease measures with risk of renal function worsening in patients with hypertension and type 2 diabetes. In: Journal of Diabetes and its Complications. 2017 ; Vol. 31, No. 2. pp. 419-426.
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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/1.73m(2), evaluation for albuminuria and regular visits during a four-year follow-up were retrieved and analyzed. The incidence of eGFR <60mL/min/1.73m(2) 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.",
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T1 - Association of kidney disease measures with risk of renal function worsening in patients with hypertension and type 2 diabetes

AU - Viazzi, Francesca

AU - Piscitelli, Angela Pamela

AU - Giorda, Carlo

AU - Ceriello, Antonio

AU - Genovese, Stefano

AU - Russo, Giuseppina T

AU - Fioretto, Paola

AU - Guida, Pietro

AU - De Cosmo, Salvatore

AU - Pontremoli, Roberto

AU - AMD-Annals Study Group

N1 - Copyright © 2016 Elsevier Inc. All rights reserved.

PY - 2017/2

Y1 - 2017/2

N2 - 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/1.73m(2), evaluation for albuminuria and regular visits during a four-year follow-up were retrieved and analyzed. The incidence of eGFR <60mL/min/1.73m(2) 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.

AB - 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/1.73m(2), evaluation for albuminuria and regular visits during a four-year follow-up were retrieved and analyzed. The incidence of eGFR <60mL/min/1.73m(2) 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.

KW - Journal Article

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DO - 10.1016/j.jdiacomp.2016.10.030

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C2 - 27884661

VL - 31

SP - 419

EP - 426

JO - Journal of Diabetes and its Complications

JF - Journal of Diabetes and its Complications

SN - 1056-8727

IS - 2

ER -