Normoalbuminuric kidney impairment in patients with T1DM: Insights from annals initiative

Olga Lamacchia, Francesca Viazzi, Paola Fioretto, Antonio Mirijello, Carlo Giorda, Antonio Ceriello, Giuseppina Russo, Pietro Guida, Roberto Pontremoli, Salvatore De Cosmo

Research output: Contribution to journalArticle

Abstract

Background: We described, in a large sample of patients with type 1 diabetes mellitus (T1DM) and GFR ≤ 60 mL/min/1.73 m2 (with or without albuminuria), the differences in the clinical features associated with the two different chronic kidney disease phenotypes and we investigated, in a subset of patients, the modulating role of albuminuria on kidney disease progression. Methods: Clinical data of 1395 patients with T1DM were extracted from electronic medical records. Results: Albuminuria was detected in 676 (48.5%) patients, with the remaining 719 (51.5%) patients having normoalbuminuric renal impairment. Those with albuminuria showed an evident worse cardiovascular risk profile as compared to patients with normoalbuminuria. A subgroup of 582 patients was followed up over a 4-year period. One hundred and twenty five patients (21.5%) showed a loss of eGFR > 30%. The proportion of patients reaching the renal outcome was significantly higher among those with baseline albuminuria as compared to patients with normoalbuminuria (P < 0.0001). At the multivariate logistic analysis microalbuminuria, macroalbuminuria and proliferative retinopathy were the only parameters independently associated to eGFR reduction. Conclusions: The proportion of T1DM patients with normoalbuminuria renal impairment is high (about 50%). These patients have a slower eGFR decline as compared to that observed in patients with albuminuria renal impairment.

Original languageEnglish
Article number60
JournalDiabetology and Metabolic Syndrome
Volume10
Issue number1
DOIs
Publication statusPublished - Jul 31 2018

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Type 1 Diabetes Mellitus
Kidney
Albuminuria
Electronic Health Records
Kidney Diseases
Chronic Renal Insufficiency
Disease Progression
Multivariate Analysis
Phenotype

Keywords

  • Albuminuria
  • Cardiovascular disease
  • Chronic kidney disease
  • Type 1 diabetes mellitus

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Normoalbuminuric kidney impairment in patients with T1DM : Insights from annals initiative. / Lamacchia, Olga; Viazzi, Francesca; Fioretto, Paola; Mirijello, Antonio; Giorda, Carlo; Ceriello, Antonio; Russo, Giuseppina; Guida, Pietro; Pontremoli, Roberto; De Cosmo, Salvatore.

In: Diabetology and Metabolic Syndrome, Vol. 10, No. 1, 60, 31.07.2018.

Research output: Contribution to journalArticle

Lamacchia, O, Viazzi, F, Fioretto, P, Mirijello, A, Giorda, C, Ceriello, A, Russo, G, Guida, P, Pontremoli, R & De Cosmo, S 2018, 'Normoalbuminuric kidney impairment in patients with T1DM: Insights from annals initiative', Diabetology and Metabolic Syndrome, vol. 10, no. 1, 60. https://doi.org/10.1186/s13098-018-0361-2
Lamacchia, Olga ; Viazzi, Francesca ; Fioretto, Paola ; Mirijello, Antonio ; Giorda, Carlo ; Ceriello, Antonio ; Russo, Giuseppina ; Guida, Pietro ; Pontremoli, Roberto ; De Cosmo, Salvatore. / Normoalbuminuric kidney impairment in patients with T1DM : Insights from annals initiative. In: Diabetology and Metabolic Syndrome. 2018 ; Vol. 10, No. 1.
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AU - Viazzi, Francesca

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AU - Giorda, Carlo

AU - Ceriello, Antonio

AU - Russo, Giuseppina

AU - Guida, Pietro

AU - Pontremoli, Roberto

AU - De Cosmo, Salvatore

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AB - Background: We described, in a large sample of patients with type 1 diabetes mellitus (T1DM) and GFR ≤ 60 mL/min/1.73 m2 (with or without albuminuria), the differences in the clinical features associated with the two different chronic kidney disease phenotypes and we investigated, in a subset of patients, the modulating role of albuminuria on kidney disease progression. Methods: Clinical data of 1395 patients with T1DM were extracted from electronic medical records. Results: Albuminuria was detected in 676 (48.5%) patients, with the remaining 719 (51.5%) patients having normoalbuminuric renal impairment. Those with albuminuria showed an evident worse cardiovascular risk profile as compared to patients with normoalbuminuria. A subgroup of 582 patients was followed up over a 4-year period. One hundred and twenty five patients (21.5%) showed a loss of eGFR > 30%. The proportion of patients reaching the renal outcome was significantly higher among those with baseline albuminuria as compared to patients with normoalbuminuria (P < 0.0001). At the multivariate logistic analysis microalbuminuria, macroalbuminuria and proliferative retinopathy were the only parameters independently associated to eGFR reduction. Conclusions: The proportion of T1DM patients with normoalbuminuria renal impairment is high (about 50%). These patients have a slower eGFR decline as compared to that observed in patients with albuminuria renal impairment.

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