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Predictors of estimated GFR decline in patients with type 2 diabetes and preserved kidney function.
Clin J Am Soc Nephrol. 2012 Mar; 7(3):401-8.CJ

Abstract

BACKGROUND AND OBJECTIVES

This study examined predictors of the annual decline in estimated GFR (eGFR) in patients with type 2 diabetes and preserved kidney function.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

In a prospective, observational cohort study, 1682 individuals with type 2 diabetes and baseline eGFR ≥60 ml/min per 1.73 m(2) (as estimated by the Chronic Kidney Disease Epidemiology Collaboration equation) were followed for 10 years. Linear regression was used to estimate participants' changes in eGFR over time.

RESULTS

During follow-up, 263 (15.6%) individuals had a rapid eGFR decline defined as >4.0% per year. Average eGFR decline was -5.8 ± 3 and -0.6 ± 2 ml/min per 1.73 m(2) per year in rapid decliners and nondecliners, respectively. Compared with normotensive, normoalbuminuric patients (-0.2 ± 0.2 ml/min per 1.73 m(2) per year), those with hypertension (-1.0 ± 0.1 ml/min per 1.73 m(2) per year), hemoglobin A(1c)≥7% (-1.0 ± 0.1 ml/min per 1.73 m(2) per year), longer diabetes duration (-1.0 ± 0.1 ml/min per 1.73 m(2) per year), obesity (-1.2 ± 0.1 ml/min per 1.73 m(2) per year), insulin treatment (-1.5 ± 0.1 ml/min per 1.73 m(2) per year), microalbuminuria (-1.3 ± 0.2 ml/min per 1.73 m(2) per year), or macroalbuminuria (-2.7 ± 0.4 ml/min per 1.73 m(2) per year) had significantly faster age-adjusted annual eGFR declines. Multivariable linear regression analyses revealed that albuminuria (P<0.001) was the strongest predictor of annual eGFR decline. Other independent predictors of annual eGFR decline were older age, hypertension, insulin treatment, and lower baseline eGFR.

CONCLUSIONS

Annual eGFR decline is predicted by multiple modifiable risk factors in patients with type 2 diabetes and preserved kidney function.

Authors+Show Affiliations

Section of Endocrinology and Metabolism, Department of Medicine, University of Verona, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22282481

Citation

Zoppini, Giacomo, et al. "Predictors of Estimated GFR Decline in Patients With Type 2 Diabetes and Preserved Kidney Function." Clinical Journal of the American Society of Nephrology : CJASN, vol. 7, no. 3, 2012, pp. 401-8.
Zoppini G, Targher G, Chonchol M, et al. Predictors of estimated GFR decline in patients with type 2 diabetes and preserved kidney function. Clin J Am Soc Nephrol. 2012;7(3):401-8.
Zoppini, G., Targher, G., Chonchol, M., Ortalda, V., Negri, C., Stoico, V., & Bonora, E. (2012). Predictors of estimated GFR decline in patients with type 2 diabetes and preserved kidney function. Clinical Journal of the American Society of Nephrology : CJASN, 7(3), 401-8. https://doi.org/10.2215/CJN.07650711
Zoppini G, et al. Predictors of Estimated GFR Decline in Patients With Type 2 Diabetes and Preserved Kidney Function. Clin J Am Soc Nephrol. 2012;7(3):401-8. PubMed PMID: 22282481.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of estimated GFR decline in patients with type 2 diabetes and preserved kidney function. AU - Zoppini,Giacomo, AU - Targher,Giovanni, AU - Chonchol,Michel, AU - Ortalda,Vittorio, AU - Negri,Carlo, AU - Stoico,Vincenzo, AU - Bonora,Enzo, Y1 - 2012/01/26/ PY - 2012/1/28/entrez PY - 2012/1/28/pubmed PY - 2012/7/4/medline SP - 401 EP - 8 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 7 IS - 3 N2 - BACKGROUND AND OBJECTIVES: This study examined predictors of the annual decline in estimated GFR (eGFR) in patients with type 2 diabetes and preserved kidney function. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a prospective, observational cohort study, 1682 individuals with type 2 diabetes and baseline eGFR ≥60 ml/min per 1.73 m(2) (as estimated by the Chronic Kidney Disease Epidemiology Collaboration equation) were followed for 10 years. Linear regression was used to estimate participants' changes in eGFR over time. RESULTS: During follow-up, 263 (15.6%) individuals had a rapid eGFR decline defined as >4.0% per year. Average eGFR decline was -5.8 ± 3 and -0.6 ± 2 ml/min per 1.73 m(2) per year in rapid decliners and nondecliners, respectively. Compared with normotensive, normoalbuminuric patients (-0.2 ± 0.2 ml/min per 1.73 m(2) per year), those with hypertension (-1.0 ± 0.1 ml/min per 1.73 m(2) per year), hemoglobin A(1c)≥7% (-1.0 ± 0.1 ml/min per 1.73 m(2) per year), longer diabetes duration (-1.0 ± 0.1 ml/min per 1.73 m(2) per year), obesity (-1.2 ± 0.1 ml/min per 1.73 m(2) per year), insulin treatment (-1.5 ± 0.1 ml/min per 1.73 m(2) per year), microalbuminuria (-1.3 ± 0.2 ml/min per 1.73 m(2) per year), or macroalbuminuria (-2.7 ± 0.4 ml/min per 1.73 m(2) per year) had significantly faster age-adjusted annual eGFR declines. Multivariable linear regression analyses revealed that albuminuria (P<0.001) was the strongest predictor of annual eGFR decline. Other independent predictors of annual eGFR decline were older age, hypertension, insulin treatment, and lower baseline eGFR. CONCLUSIONS: Annual eGFR decline is predicted by multiple modifiable risk factors in patients with type 2 diabetes and preserved kidney function. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/22282481/Predictors_of_estimated_GFR_decline_in_patients_with_type_2_diabetes_and_preserved_kidney_function_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=22282481 DB - PRIME DP - Unbound Medicine ER -