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Glomerular filtration rate, cardiorenal end points, and all-cause mortality in type 2 diabetic patients.
Diabetes Care. 2006 Sep; 29(9):2046-52.DC

Abstract

OBJECTIVE

Chronic kidney disease (CKD) predicts cardiovascular disease (CVD) in the general population. We investigated the effects of stages of renal function using the estimated glomerular filtration rate (eGFR) on all-cause mortality and cardiovascular end points in a prospective cohort of Chinese type 2 diabetic patients.

RESEARCH DESIGN AND METHODS

Between 1995 and 2000, 4,421 patients without macrovascular disease or end-stage renal disease were recruited. Renal function was assessed by eGFR, as calculated by the abbreviated Modification of Diet in Renal Disease Study Group formula. Clinical end points included all-cause mortality, cardiovascular end point (cardiovascular death, new admissions due to angina, myocardial infarction, stroke, revascularization, or heart failure), and renal end point (reduction in eGFR by >50%, progression of eGFR to stage 5, or dialysis or renal death).

RESULTS

After a median follow-up period of 39.4 months (interquartile range 20.3-55), all-cause mortality rate increased from 1.2% (95% CI 0.8-1.7) to 18.3% (9.1-27.5) (P for trend <0.001) as renal function deteriorated from stage 1 (eGFR > or =90 ml/min per 1.73 m(2)) to stage 4 (15-29 ml/min per 1.73 m(2)). The respective rate of new cardiovascular end points also increased from 2.6% (2.0-3.3) to 25.3% (15.0-35.7) (P for trend <0.001). After adjustment for covariates (age, sex, albuminuria, use of renin-angiotensin-aldosterone system [RAAS] inhibitors, lipids, blood pressure, and glycemic control), hazard ratios across different stages of eGFR (> or =90, 60-89, 30-59, and 15-29 ml/min per 1.73 m(2)) for all-cause mortality were 1.00, 1.27, 2.34, and 9.82 (P for trend <0.001), for cardiovascular end points were 1.00, 1.04, 1.05, and 3.23 (P for trend <0.001), and for renal end points were 1.00, 1.36, 3.34, and 27.3 (P for trend <0.001), respectively.

CONCLUSIONS

Chinese type 2 diabetic patients with reduced eGFR were at high risk of developing cardiovascular end points and all-cause mortality, independent of albuminuria and metabolic control.

Authors+Show Affiliations

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong SAR.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16936151

Citation

So, Wing Yee, et al. "Glomerular Filtration Rate, Cardiorenal End Points, and All-cause Mortality in Type 2 Diabetic Patients." Diabetes Care, vol. 29, no. 9, 2006, pp. 2046-52.
So WY, Kong AP, Ma RC, et al. Glomerular filtration rate, cardiorenal end points, and all-cause mortality in type 2 diabetic patients. Diabetes Care. 2006;29(9):2046-52.
So, W. Y., Kong, A. P., Ma, R. C., Ozaki, R., Szeto, C. C., Chan, N. N., Ng, V., Ho, C. S., Lam, C. W., Chow, C. C., Cockram, C. S., Chan, J. C., & Tong, P. C. (2006). Glomerular filtration rate, cardiorenal end points, and all-cause mortality in type 2 diabetic patients. Diabetes Care, 29(9), 2046-52.
So WY, et al. Glomerular Filtration Rate, Cardiorenal End Points, and All-cause Mortality in Type 2 Diabetic Patients. Diabetes Care. 2006;29(9):2046-52. PubMed PMID: 16936151.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glomerular filtration rate, cardiorenal end points, and all-cause mortality in type 2 diabetic patients. AU - So,Wing Yee, AU - Kong,Alice P S, AU - Ma,Ronald C W, AU - Ozaki,Risa, AU - Szeto,Cheuk Chun, AU - Chan,Norman N, AU - Ng,Vanessa, AU - Ho,Chung Shun, AU - Lam,Christopher W K, AU - Chow,Chun Chung, AU - Cockram,Clive S, AU - Chan,Juliana C N, AU - Tong,Peter C Y, PY - 2006/8/29/pubmed PY - 2007/1/9/medline PY - 2006/8/29/entrez SP - 2046 EP - 52 JF - Diabetes care JO - Diabetes Care VL - 29 IS - 9 N2 - OBJECTIVE: Chronic kidney disease (CKD) predicts cardiovascular disease (CVD) in the general population. We investigated the effects of stages of renal function using the estimated glomerular filtration rate (eGFR) on all-cause mortality and cardiovascular end points in a prospective cohort of Chinese type 2 diabetic patients. RESEARCH DESIGN AND METHODS: Between 1995 and 2000, 4,421 patients without macrovascular disease or end-stage renal disease were recruited. Renal function was assessed by eGFR, as calculated by the abbreviated Modification of Diet in Renal Disease Study Group formula. Clinical end points included all-cause mortality, cardiovascular end point (cardiovascular death, new admissions due to angina, myocardial infarction, stroke, revascularization, or heart failure), and renal end point (reduction in eGFR by >50%, progression of eGFR to stage 5, or dialysis or renal death). RESULTS: After a median follow-up period of 39.4 months (interquartile range 20.3-55), all-cause mortality rate increased from 1.2% (95% CI 0.8-1.7) to 18.3% (9.1-27.5) (P for trend <0.001) as renal function deteriorated from stage 1 (eGFR > or =90 ml/min per 1.73 m(2)) to stage 4 (15-29 ml/min per 1.73 m(2)). The respective rate of new cardiovascular end points also increased from 2.6% (2.0-3.3) to 25.3% (15.0-35.7) (P for trend <0.001). After adjustment for covariates (age, sex, albuminuria, use of renin-angiotensin-aldosterone system [RAAS] inhibitors, lipids, blood pressure, and glycemic control), hazard ratios across different stages of eGFR (> or =90, 60-89, 30-59, and 15-29 ml/min per 1.73 m(2)) for all-cause mortality were 1.00, 1.27, 2.34, and 9.82 (P for trend <0.001), for cardiovascular end points were 1.00, 1.04, 1.05, and 3.23 (P for trend <0.001), and for renal end points were 1.00, 1.36, 3.34, and 27.3 (P for trend <0.001), respectively. CONCLUSIONS: Chinese type 2 diabetic patients with reduced eGFR were at high risk of developing cardiovascular end points and all-cause mortality, independent of albuminuria and metabolic control. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/16936151/Glomerular_filtration_rate_cardiorenal_end_points_and_all_cause_mortality_in_type_2_diabetic_patients_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=16936151 DB - PRIME DP - Unbound Medicine ER -