Changes in albuminuria and renal outcome in patients with type 2 diabetes and hypertension: a real-life observational study

Objectives: To assess the predictive role of changes in albuminuria on the loss of renal function under antihypertensive treatment in patients with type 2 diabetes (T2D). Methods: Clinical records from a total of 12 611 patients with hypertension and T2D, attending 100 antidiabetic centers in Italy, with normal estimated glomerular filtration rate (eGFR) at baseline and regular visits during a 4-year period were retrieved and analyzed. We assessed the association between changes in albuminuria status during a 1-year baseline period and time updated blood pressure (BP) and eGFR loss over the subsequent 4-year follow-up. Results: Mean age at baseline was 65 +/- 9 years, known duration of diabetes11 +/- 8 years, eGFR 85 +/- 13 ml/min and BP 142 +/- 17/81 +/- 9 mmHg. Patients with persistent albuminuria showed the highest 4-year risk of eGFR loss more than 30% from baseline or onset of stage 3 chronic kidney disease (eGFR